Nicholas J. Vianna

Suppression of chronic lymphocytic leukemia by polycythemia vera

A patient with a 5‐year history of asymptomatic chronic lymphocytic leukemia developed polycythemia vera with a reduction in absolute lymphocyte counts and bone marrow lymphocytes. In vitro phytohemagglutinin stimulation studies performed at this time demonstrated a reduction below normal in the percent of lymphocytes that were transformed to blast cells. After several phlebotomies of whole blood, a significant increase in absolute lymphocyte count and bone marrow lymphocytes was observed. Subsequent follow‐up revealed a gradual increase in hematocrit and absolute granulocyte count and a simultaneous decrease in the absolute lymphocyte count. These findings strongly suggest that the preexisting chronic lymphocytic leukemia was suppressed by the polycythemic process.

Epidemiologic and histologic patterns of Hodgkin's disease in blacks.

The epidemiologic pattern for Hodgkins disease in blacks from two different communities in the United States was characterized by higher childhood rates and significantly lower rates in the young adult and older age groups than for whites. In addition, a significantly greater number of black patients belonged to low occupational groups. These observations and the different epidemiologic patterns for blacks in Southern Transvaal, South Africa, and other countries suggest that the natural history of Hodgkins disease might be strongly influenced by social milieu. The variability in Rye subtype distribution, particularly for whites and blacks in the young adult and other age groups raise the possibility that age related environmental factors might be important in the histologic reactivity of the host. Cancer 40:3133‐3139, 1977.

Epidemiologic patterns of frontal and maxillary sinus cancer

A significant decrease in mortality rates for maxillary and frontal sinus cancer was found for older females, particularly in urban areas of New York State, over a 30‐year period. A similar observation was made for males residing in rural areas. The decline in female rates might be related to the discontinued use of carcinogenic agents such as Thorotrast, whereas that in males might be related to changes in those industries associated with an increased risk for these cancer sites.

One man’s view of Hodgkin's disease

SummaryDespite its many heterogeneous features, Hodgkins disease is most likely a single neoplastic disorder in which some common viral agent of low virulence and infectivity might be of etiologic importance. Family factors such as birth order influence age of initial exposure, a major determinant of the outcome of infection—clinical disease versus immunity. The various epidemiologic patterns for this lymphoma observed internationally are probably a reflection of different levels of natural immunity acquired in childhood. Host factors might be responsible for the male excess of Hodgkins disease, particularly in childhood.