Hodgkin's Disease

Abstract

Immunologic function was evaluated in 50 untreated patients with active Hodgkin''s disease studied shortly after their initial diagnostic biopsies. The results were related to the clinical stage and histologic classification of disease. The impairment of delayed hypersensitivity was much less than previously reported for patients who had received therapy or who had prolonged active disease. Thirty-five of the 50 patients (70%) were sensitized to dinitrochlorobenzene and 28 (56%) were reactive to at least 1 intradermal microbial antigen. Only 16% failed to react to all tests of delayed hypersensitivity. Circulating antibody responses following tularemia immunization were normal in 94% of the patients. Delayed hypersensitivity in patients with well-localized disease (Stage I) was normal, but a significant decrease in skin reactivity was observed in patients with more extensive disease (Stages II, III and IV). Impairment of delayed hypersensitivity occurred most often in those patients with peripheral lymphocytopenia or with lymphocyte depletion in their biopsied lymph nodes. Lymphocyte transformation to phyto-hemagglutinin in vitro was low in the patients and lowest in those patients with cutaneous energy. Thus, the impairment of delayed hypersensitivity in patients with untreated Hodgkin''s disease may be a reflection of an inadequate quantity of normally functioning lymphocytes.