Evidence that amphotericin B mediates reactivation of latent Epstein-Barr virus in Hodgkin's lymphoma allowing cytotoxicity by acyclovir.
This brief communication focuses on aspects of a recent case report (Yonsei Med J 2005;46:425-30) on a full and sustained remission of Hodgkin's lymphoma (HL) after a single day of chemotherapy. A septic episode required stopping chemotherapy and starting amphotericin B and acyclovir. Remission evidence was seen within days of starting these. A review of research supporting the notion that amphotericin B can reactivate latent Epstein-Barr virus and thus allow acyclovir to kill infected HL cells is given. Experimental work is required to confirm or refute this possibility. If successful, amphotericin B and acyclovir treatment could be extended to other EBV-driven cancers such as Burkitt's lymphoma, nasopharyngeal carcinoma and the occasional EBV-related epithelial cancer of the breast, colon, prostate, and others.
Kast
Richard E
RE
University of Vermont, 2 Church Street, Burlington, VT 05401, USA. kast887@hotmail.com
D000212:Acyclovir / Q000627:therapeutic use*; D000666:Amphotericin B / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002051:Burkitt Lymphoma / Q000821:virology; D004357:Drug Synergism; D015774:Ganciclovir / Q000627:therapeutic use; D004854:Herpesvirus 4, Human / Q000378:metabolism*; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000821:virology*; D006801:Humans; D012074:Remission Induction; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014775:Virus Activation
D000900:Anti-Bacterial Agents; D014409:Tumor Necrosis Factor-alpha; D000666:Amphotericin B; D015774:Ganciclovir; D000212:Acyclovir