San Francisco Chronicle - Saturday June 10, 1989
David Perlman, Chronicle Science Editor

Their report, presented at a closing scientific session of the fifth International AIDS Conference, envisions possible new treatments for the common and deadly tumors called B-cell lymphomas.

Those tumors form among cells in the lymph glands that become painfully swollen inside the neck, armpit and groin.

In people with AIDS, the cancers strike crucial elements of the body's immune system - the B-cells that would normally mature to produce infection-fighting antibodies. The B-cells become swelling clumps of malignant tissue that resist high doses of conventional anti-cancer drugs, which weaken their damaged immune systems even further. The tumors are so aggressive that they do not respond to lower chemotherapy doses.

Dr. Brian Herndier, a University of California pathologist at San Francisco General Hospital and his colleagues at the University of California at San Francisco said they have now tracked the cause of the B-cell lymphomas and are proposing new ways of treating them.

B-cells in the human body, they know, are incredibly diverse, and each may carry any one among literally tens of millions of antibody proteins called immunoglobulins on their surface.

The AIDS Link

Using techniques that Herndier calls "tough immunology and tough cancer biology," the UC group has determined that in AIDS patients those B-cell lymphomas are triggered when antigen molecules carried on the surface of the infamous AIDS virus bind to the T-cells and macrophages of the immune system.

Dr. Richard Miller, a former UCSF cancer specialist, has formed a small biotechnology firm called IDEC Pharmaceuticals in Mountain View and has joined the group working with Herndier at San Francisco General Hospital. Miller has made a variety of complex compounds called monoclonal antibodies by fusing mouse spleen cells to human lymphoma cells taken from AIDS patients. These fused tumor cells, called hybridomas, carry specialized antibodies designed to boost the immune system so it can act against a wide range of antigens on the surface of the AIDS virus.

Working together, Herndier, Miller and their colleagues have shown that in AIDS patients the B-cell lymphomas are in fact driven by a chain of reactions to the invasion of HIV, the human immunodeficiency virus that causes AIDS itself.

Gene Theories

This discovery of the cancer-causing role of HIV flies in the face of more widely held beliefs that lymphomas and many other cancers arise as a result of cancer-causing genes called oncogenes, which are activated by chemicals, viruses or radiation.

In the new concepts described this week, antigens on the surface of the AIDS virus drive the formation of lymphomas directly, and this could explain why in AIDS patients those cancers arise so swiftly and spread so aggressively.

The concept could also lead to at least two new approaches to therapy. One, according to Herndier, would be to attack the lymphomas by injecting patients with Miller's antibody-bearing hybridomas.

If the B-cell lymphomas are in fact caused by a chain reaction initiated by the AIDS virus, then another possible therapy should be to eliminate the virus itself from the patients, Herndier suggested.

This means using a powerful anti-viral agent such as AZT. Although that drug has already proven useful in prolonging the life of many AIDS patients, it has not shown any effect on the lymphomas that strike thousands of them.

A dozen clinical trials of other anti-viral drugs have already begun, and according to corridor talk by many researchers at the conference, one of them is the newly reported substance widely known as "Compound Q." It is made by purifying a protein called tricosanthin from the tuber of a Chinese cucumber. Human tests of the drug's safety have just begun.

Always watch for outdated information. This article first appeared in 1989. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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