The investigation of the cellular type of immunity in patients with lymphoproliferative and myeloproliferative diseases

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Abstract
Delayed hypersenstivity to streptokinase and tuberculin used as antigens, and the capacity to form antibodies to streptokinase, were investigated in various malignant blood diseases and the results were compared with those found in some other diseases and in a control group of healthy subjects.It was found that anergy similar to that seen in Hodgkin's disease (also confirmed in this work) can be found with regard to two antigens in reticulosarcoma, myeloma, acute leukaemia and chronic myelosis. In myelofibrosis partial anergy was observed only with streptokinase but not with tuberculin antigen. The anergy was in general not correlated with the absolute lymphocyte count in the peripheral blood nor with the treatment given.The increase in antistreptokinase antibodies after immunization with streptokinase was investigated. This administration of the antigen (secondary response) gave results which did not differ from those in controls in Hodgkin's disease, reticulosarcoma, acute leukaemia and chronic myelosis. In myeloma and especially in chronic lymphatic leukaemia, however, the antibody‐forming capacity was significantly decreased. Thus, the results point to a dissociation in the immunological response: in Hodgkin's disease, reticulosarcoma, acute leukaemia and chronic myelosis, there is a significant decrease in the response of the cellular type with preservation of antibody‐forming power. In myeloma both types of reactions are decreased. In chronic lymphatic leukaemia antibody‐forming capacity is reduced with relatively good preservation of the cellular type of reactivity.Delayed hypersensitivity to tuberculin was also depressed in patients with sarcoidosis although tested during remission, whereas skin sensitivity to streptokinase was preserved. In patients with pancytopenia the delayed hypersensitivity was only slightly suppressed, but there was a tendency to produce higher antibody titres against streptokinase than in the controls, although the difference was not statistically significant. There were similar findings in patients with autoimmune haemolytic anaemia.