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Ree fifths of your antenatal females infected (three of 5 constructive among 3522 tested) have been found to become white. If this was also correct in the blood donor population, four new donors in the West Midlands area throughout 1988-99 would most most likely have had antibodies to HTLV-I. There have been roughly 20 000 new donors a year in the area for the duration of this 11 year period, which suggests that 4 in 220 000 new donors (roughly one particular in 55 000) have been carrying HTLV-1. A prevalence of 0.11 is Nigericin (sodium salt) considerably reduced than the 0.55 identified within a similarly selected group of 1100 Afro-Caribbean blood donors in South Thames area (J Value, private communication). It’s difficultBMJ VOLUME 321 five AUGUST 2000 bmj.comAuthors’ reply Editor–Palmieri et al emphasise the part with the lately identified oestrogen receptor . This might indeed grow to be a helpful tumour marker within the future. For our review, however, we were asked to include things like only tumour markers known to be of typical clinical use. Which is why we did not discuss various new and potentially interesting markers. Dalgleish points out that in lots of hospitals the marker CA19.9 is frequently utilized clinically, not just experimentally. The usage of numerous markers varies, and we tried to choose these most generally employed worldwide and point them out as being clinically made use of; which is why we mentioned that CA125 was in popular clinical use and CA19.9 was nonetheless experimental. The marker lactate dehydrogenase is commonly employed in follow up in lymphoma (as well as in other malignancies). This marker was incorporated in the original version of our write-up, but we ultimately excluded it since it is definitely an unspecific marker of cell decomposition (destruction) and does not fit the criteria we have been told to work with for any tumour marker. Apart from, it’s utilised mostly as a prognostic marker, and we removed all prognostic markers on request in the reviewer. Colls points out the usefulness of your marker human chorionic gonadotrophin within the management of molar pregnancies and subsequent choriocarcinoma. This marker is certainly of use, but, probably erroneously, we omitted it and also other markers employed in pretty uncommon diseases.. . . as are monoclonal immunoglobulin and human chorionic gonadotrophin Editor–Lindblom and Liljegren’s critique of tumour markers in malignancies is especially intriguing to these keen on the genetic and molecular biological elements of this subject.1 Concentration on these topics, even so, has resulted in the authors failing to emphasise the significance from the tumour markers which have been in clinical use for a lot of years. No mention is created of monoclonal immunoglobulin, that is certainly the oldest tumour marker recognized and is most likely by far the most extensively utilised. Certainly, the presence of monoclonal immunoglobulin in blood or urine is one of the prerequisites in diagnosing myeloma. Its measurement can also be utilised in staging and prognosis, and alterations just after therapy are valuable in management.2 Therefore it can be pretty much the perfect tumour marker with regards to diagnosis,Lettersto explain the reduced prevalence in the West Midlands, but 3 quarters of AfroCaribbean donors there are aged below 40 and so have been possibly born inside the Uk. They may possess a decrease seroprevalence of HTLV-I than the Afro-Caribbean population of London owing either to an age effect or their birth in the United kingdom.John Kurtz PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20016286 consultant virologist Neil Smith consultant haematologist [email protected] National Blood Service, Birmingham B15 2SG Steve Harbour healthcare laboratory s.