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Letter from Joshua Lederberg to Edward P. Radford

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  • Medicine


STANFORD UNIVERSITY MEDICAL CENTER DEPARTMENT OF GENETICS November 22, 1977 Professor Edward P. Radford Department of Epidemiology Graduate School of Public Health University of Pittsburgh Pittsburgh, PA. 15261 Dear Professor Radford: Thank you for your letter of November 16th and the reprints which I was glad to have for aloser perusal. Your studies do answer the questions about inherent predisposition to cancer on the part of patients with ankylosing spondylitis. There was, however, a variant of that;question that is recited in your letter, but which I believe would be difficult to address from any of the available data. That is the postulation, that these patients, owing to the underlying immunological disturb- ance, may have a response to radiation which is not typical'.of that of the, bulk population. There is no reason a priori to suggest whether they should be more or less sensitive in the yield of cancers per unit radiation dose. It is not at all implausible that there should be a difference. This kind of inter- action may appear less far fetched if one looks at tuberculosis from a similar point of view: there is certainly no reason to believe that the patients have had a different exposure to the organism, but your own statistics suggest a different interaction with it. It may be futile to suggest such elaborate interactions if there are no experimental or observational data with which to check them: However, if there are discrepancies in case yield in the spondylitis series, compared to other observations, there may be some point in reviving these distinctions. Experimentally, the most useful would be studies on the interaction be- tween immunosuppression and radiation effect, and if you have been able to find any instances of such efforts I would be most interested to hear about them. I am glad to know about your new role on BEIR and hope that we might be in some contact about these questions from time to time. If Jim Crow r

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