ANP is an uncommon disease: its incidence has been estimated to be 13.8 per 10 000 admissions. 1 Situations that decrease salivary blood flow such as dehydration, low birth weight, medications, prematurity, and orogastric tube feeding are recognized as risk factors. [2][3][4]

Titration of anti-complementary human sera may yield false negative or prozone reactions in anti-complement immunofliiorescence (ACIF) tests for antibodies to Epstein-Barr virus-associated nuclear antigen ( E B N A ) when the human complement ( C ' ) is added to the serum dilutions prior to charging of the target cell smears (twostage ACIF test). This effect of anti-complementary sera and with it a source of error is avoided by using a three-stage ACIF

No abstract

Antibodies against several EB V-and non-EB V-associated antigens were titrated in serial sera from a patient with Burkitt's lymphoma who was given immune stimulants during chemotherapeutically induced tumor regression. EBV-associated membrane reactive antibodies gradually declined during BCG treatment 3-4 months prior to triple (pertussis-diphtheria-tetanus, PD T ) vaccination, after which they rapidly increased simultaneously with the appearance of multiple recurrent tumors. Prior to vaccination, antibodies to the R component of the EBV-induced early antigen complex became detectable and increased further before the recurrences became evident. Antibodies to EB viral capsid antigens and to the D component of the early antigen complex also increased starting after triple vaccination, whereas most other antibodies studied remained stable during the observation period. Possible interpretations of the serological changes are discussed.Burkitt's lymphoma (BL) has offered the possibility of immunological studies following immune stimulant treatment of a neoplastic disease. Several defined antigen-antibody systems associated with the Epstein-Barr virus (EBV) exist: the cell membrane antigens, MA (Klein et a/., 1966), the EBV-induced early antigens, EA, of R or D specificity (Henle et al., 1970, Henle et al., 197!a), and the viral capsid antigens, VCA (Henle and Henle, 1966). BL patients have the corresponding antibodies at higher frequency and at higher levels than controls Gunven et al., 1970; Henle et al., 19716). These antibodies appear to be disease-related in BL patients, as indicated by decreasing anti-MA reactivity before recurrence in one patient , high risk for recurrences and death in patients with high anti-EA titers, as compared to patients with low anti-EA reactivity (Henle et al., 1971b), changing anti-MA, anti-EA, and anti-VCA titers during local radiotherapy of B L tumors (Einhorn et al., 1972), and changes of the spectrum and titers of antibodies to EA that could be related to clinical events like recurrences, death, or tumor-free survival .A study of EBV-associated antibodies during BCG treatment of clinically tumor-free BL Received: February 22, 1973.Present address: The Royal Marsden Hospital, London and Surrey, Sutton, Surrey, England. 115G U N V~N ET AL.patients revealed that only the anti-MA titers regularly showed significant changes during the treatment in the form of transitory peaks or a prolonged elevation. The titers, as a rule, returned, however, to pre-treatment values or slightly above during the latter part of the BCG treatment, and it was speculated that an increasing immunization against BCG decreased its non-specific action on the immune system. If this were the case, it would be logical to replace BCG by another immune stimulant. Since Bordetella pertussis, in combination with diphtheria and tetanus toxoid in a '' triple vaccine " (PDT) had been used previously for this purpose in BL patients without apparent adverse effects (Clifford et al., 1967) it was selected for use after BL ...