Immune status of untreated patients with Hodgkin's disease and prognosis.
In this study of 127 previously untreated adult patients with Hodgkin's disease and 167 age- and sex-matched controls, highly purified blood lymphocytes were studied for E+ receptors; their spontaneous DNA synthesis and that induced by concanavalin A, pokeweed mitogen, or purified protein derivative of tuberculin were measured as incorporation of 14C-thymidine. T-cell counts and the response to mitogens and antigen were significantly decreased in the patients, while the spontaneous lymphocyte activity was increased. Forty-nine patients had died after a mean observation time of 6 years. In these patients, there had been an increase in spontaneous DNA synthesis and a decrease in that induced by mitogens and antigen. These differences also remained significant when patients who died were compared with surviving patients in stages I-II. The 5-year survival rate of "bad immunology" patients was 30% as compared to 80% for the remainder. We suggest that these lymphocyte tests should be considered in an "immunologic staging system," which may give guidance in the future management of patients with Hodgkin's disease.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003208:Concanavalin A / Q000494:pharmacology; D005260:Female; D006689:Hodgkin Disease / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D006968:Hypersensitivity, Delayed; D007111:Immunity, Cellular; D007958:Leukocyte Count; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011043:Pokeweed Mitogens / Q000494:pharmacology; D012397:Rosette Formation; D012882:Skin Tests
D011043:Pokeweed Mitogens; D003208:Concanavalin A