Science / Medicine : AIDS Remission After Risky Heat Treatment Raises Curiosity
A report suggesting that a risky and experimental body-heating procedure had resulted in a three-month remission in one AIDS patient with a form of cancer known as Kaposi’s sarcoma has spurred curiosity and interest among AIDS and cancer researchers.
According to the report, the 33-year-old patient’s Kaposi’s sarcoma lesions began disappearing within two days of undergoing “total body hyperthermia”--in which his body was heated to 108 degrees Fahrenheit--and showed “maximum” regression after six weeks. The report has been submitted for publication--but not yet accepted--in the journal Medical Oncology and Tumor Pharmocotherapy.
Researchers also have been unable to find the human immunodeficiency virus (HIV) in the patient’s blood three months after the procedure, and his counts of T4 helper cells, key sentinels of the immune system, jumped dramatically after the procedure. However, because HIV is difficult to detect, other researchers said it is likely the virus is still being harbored somewhere in the man’s body.
The report was authored by Dr. William D. Logan and Dr. Kenneth Alonso of Atlanta, Ga. A copy of the report was provided to The Times after the patient, Carl Crawford, told his story to Atlanta television stations and Cable News Network.
“This is a single case report,” Alonso emphasized. “While it is promising, we have got to duplicate it and look at a lot of other things.”
Total body hyperthermia involves raising a patient’s body temperature for an extended period of time. The procedure has a long history and has been used increasingly as a treatment for certain cancers.
In this case, the Kaposi’s sarcoma patient was anesthetized and his blood flow was diverted into a machine known as a heat exchanger. The blood was heated to 115 degrees Fahrenheit, gradually raising his body temperature to 108 degrees Fahrenheit.
The elevated temperature was maintained for two hours, after which the patient was gradually cooled over a 30-minute period. The patient tolerated the procedure well and was released from the hospital three days later.
The patient’s apparent remission “is certainly a fascinating and interesting observation,” said Dr. Fred Gibbs, chief of the University of Utah’s radiation therapy section and president of the North American Hyperthermia Group, a collection of researchers interested in the procedure.
But the results “are going to have to withstand the test of scientific scrutiny and be reproduced before we can get excited about them. . . . The world of cancer research is replete with examples of single cases of dramatic remissions that cannot be widely reproduced.”
Dr. John R. McLaren, professor of radiology at Emory University and a junior editor of Medical Oncology and Tumor Pharmocotherapy, said the publication’s editors have asked the manuscript’s authors to provide additional data before they will publish the report. Alonso said he is working on the revisions.
Gibbs said that total body hyperthermia has been of help in certain forms of cancer but the results have typically been “very short-lived--a month or two.”
Dr. Mathilde Krim, founding chair of the American Foundation for AIDS Research, said: “It is theoretically possible that heat can have an anti-viral effect. It is worth trying to repeat.”
Still, Krim added, “This is a very delicate procedure that involves risk,” and “patients should not run out and demand hyperthermia.” Experiements to determine whether the procedure works “can be repeated rather rapidly and soon.”
Krim, noting that the patient had been given the drugs AZT and alpha interferon for several months before he was heated, said that “the case is a little suspect” because “interferon can have a delayed effect on Kaposi’s sarcoma.” She added that it is highly unlikely that the virus has been eradicated, since HIV seizes control of the genetic materials of the cells it attacks.
“The potential for hyperthermia as a treatment in AIDS is there,” added Dr. John E. Antoine, director of radiation research at the National Cancer Institute in Bethesda, Md. “HIV is not a very tough virus” and might not be able to withstand the heat, he added.
“We’ll have to look at the report and critique it, and see whether the result can be duplicated,” Antoine added.
