Serial studies of immunocompetence of patients undergoing chemotherapy for acute leukemia.
Immunocompetence was followed serially for 1 yr from the onset of treatment in 55 adult patients with acute leukemia. The tests used were delayed hypersensitivity responses to a battery of five recall antigens (dermatophytin, dermatophytin 0, candida, streptokinase-streptodornase, and mumps) and in vitro lymphocyte blastogenic responses to phytohemagglutinin and streptolysin 0. There was a strong correlation between immunocompetence at the start of treatment and a good prognosis; 32/39 patients who subsequently entered remission were initially immunocompetent compared to 4/15 who failed to enter remission. In the complete remission group there was a decline in competence starting from 2 to 5 mo after the onset of treatment. In those who remained in remission for 1 yr, competence recovered at 6 mo and remained vigorous thereafter. In those who relapsed before 1 yr, the decline in competence occurred 1 mo before relapse and competence continued to decline progressively during the 1 yr follow-up period. These studies suggest that therapeutic approaches which restore immunocompetence or prevent its decline will improve both the remission rate and the remission duration of patients with acute leukemia.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000917:Antibody Formation; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology; D007167:Immunotherapy; D066298:In Vitro Techniques; D037102:Lectins / Q000494:pharmacology; D007938:Leukemia / Q000188:drug therapy / Q000276:immunology*; D007945:Leukemia, Lymphoid / Q000188:drug therapy / Q000276:immunology*; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000276:immunology*; D008213:Lymphocyte Activation; D008214:Lymphocytes; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012075:Remission, Spontaneous; D012882:Skin Tests; D013301:Streptolysins / Q000494:pharmacology; D014750:Vincristine / Q000627:therapeutic use
D000970:Antineoplastic Agents; D037102:Lectins; D013301:Streptolysins; D003561:Cytarabine; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone