Delayed skin test responses to several or all of a battery of six antigens were evaluated in 64 patients with disseminated Hodgkin's disease before, during, and after multiple-agent chemotherapy. Before therapy, 53% of patients had one o r more positive skin tests, as compared to 55% during intensive chemotherapy, 79% during maintenance therapy, and 100% after discontinuation of all treatment. Pretreatment skin tests were of no value in predicting clinical response to chemotherapy. Response rates, duration of response, and survival were similar among anergic patients and patients with positive skin tests before treatment. There were too few patients who remained anergic after intensive induction chemotherapy to permit a correlation of immunologic reactivity with course. We conclude that skin test responses to recall antigens, before o r during aggressive treatment, are more indicative of Hodgkin's disease activity (and also, of the immunosuppressive effects of treatment routines) than of prognosis.
Cancer 36:950-955, 1975. E'ERAL ST1~DIES2"""3''''17'2s'27 H A V E SHO, N S that delayed hypersensitivity reactions, homograft rejection, and in vitro lymphocyte responsiveness are impaired in patients with advanced Hodgkin's disease. Previous studies from our department 13-22*26 demonstrated that: 1 ) depression of delayed hypersensitivity responses correlates with the activity of Hodgkin's disease, 2) anergic patients may regain delayed hypersensitivity responses and in vitro lymphocyte reactivity after successful treatment of disease; and 3) patients with quiescent or mildly active Stage 111 or IV disease who converted their tuberculin response after bacille Calmette-Gutkin (BCG) vaccination had substantially longer survival after this immunologic challenge than those unable t o convert their response to tuberculin, purified protein derivative (PPD). This report presents a study of the skin test reactivity of patients with Hodgkin's disease before, during, and after a multiple-agent From the Roswell Park 1,lemorial InstGute. Buffalo. NY.