Host Defences To Burkitt Tumour
Ngu V. A. (1967). Host defences to Burkitt tumour. British medical journal, 1(5536), 345–347. https://doi.org/10.1136/bmj.1.5536.345
View Original Source →Case Details
Disease Location
Right cheek, maxillae and mandible, parotid and right submental regions
Personal Characteristics
4 -year-old female
Clinical Characteristics
Admitted on 19 january 1966 with a two months history of swelling of the right cheek she had a classical burkitt tumor of the right maxilla and mandible, with extension of tumor into the parotid and right submental regions, she also had an enlarged ln in the right posterior triangle a specimen of bone marrow from the right iliac crest showed gross invasion by burkitt tumor cells; an x-ray of the facial bones showed destructive changes typical of burkitt tumor IV pyelography revealed displacement of calices by an intrarenal deposit, a biopsy of the tumor disclosed butkitt tumor cells on 20 january, after immune plasma ii (plasma donor information is in article) donor was found, she was given an infusion of 100ml of the plasma. She was also started on prophylactic tetracycline, given for 2 weeks on the fifth day after starting treatment, she developed a swinging fever of up to 102f which persisted until the 14th day. Coinciding with the onset of the fever, the jaw tumor appeared to be somewhat larger and then became softer and more cystic in consistency when tumor regression had ceased, two weeks after the plasma infusion, 500ml of fresh compatible blood from an adult nigerian was transfused without any effect on the rest of the tumor. IV cyclophosphamide was started. On the 5th day of chemo, she suddenly collapsed and died necropsy revealed partly necrotic tumor tissue that was present in the right cheek, lower cervical lymph nodes, and right femur. Histology of the cheek tumor showed few viable tumor cells, but an increase in the number of histiocytes no satisfactory anatomical cause of death was found, it was thought to have been due to hyperuricaemia consequent upon the drug-induced tumor destruction
Remission Characteristics
On the 14th day of treatment, the fever began to subside and the tumor had become smaller and its cystic consistency more evident. Serum uric acid at this time was 17.9g/100ml (4.9g/100ml on admission) after blood transfusion and cyclophosphamide, there was further regression of the tumor as well as a continued general improvement in the clinical status.
Treatment & Mechanisms
Proposed Remission Mechanisms
Immune plasma may have had a specific anti-tumor factor missing from control plasma immunological causes for regression passively transfused immunity
Clinical Treatment
Plasma infusion prophylactic tetracycline blood transfusion, IV cyclophosphamide
Non-Clinical Treatment
None reported