To assess the effects of radiotherapy on immune status, a wide range of assessments have been performed on patients with localized carcinoma of the cervix uteri undergoing and initially responding clinically to radical pelvic radiotherapy. Neutrophil function was essentially unchanged by treatment. Absolute neutrophil and lymphocyte counts fell after treatment and remained depressed 3 and 12 months following treatment. The proportions of T and B cells dropped with treatment but recovered to near-presentation levels during the follow-up period even though absolute counts remained depressed. In vitro tests of cellular immunity were depressed by treatment and remained so 3 and 12 months following treatment whereas skin test responses remained normal throughout the assessments. Inhibitory plasma effects were observed in phytohaemagglutinin lymphocyte transformation studies on 4 untreated patients; at follow-up these effects were not evident. A variable response in immune indices has therefore been observed in patients in remission after treatment of localized carcinoma cervix stressing the importance of assessing several aspects of immune function and implying that persistent depression of certain indices does not adversely affect the host tumor response. In two patients relapsing after apparently good initial response all aspects of immunological assessment (except serum immunoglobulin levels and neutrophil function) deteriorated.

Summary.-Of 100 children and adolescents with lymphoblastic leukaemia (ALL) seen over a 6-year period, 25 developed clinically evident infiltration of the central nervous system (CNS), despite early treatment with cranial radiotherapy and intrathecal methotrexate.Nine of these 25 had the features of T ALL, though there were only 17 such patients overall. Not only did those with T ALL get CNS disease more frequently, but they did so much sooner after diagnosis (P <0001) and more commonly had associated facial palsies (P <0.05). The tendency to develop CNS infiltration appeared to be significantly related to the possession of T-cell markers (P<0-02), but not to the diagnostic white cell count (P =0.37). These findings suggest that current CNS prophylactic therapy is ineffective in most patients with T ALL.

No abstract

A rapid, very simple technique for establishing fetal pulmonary maturity status is presented. Among 100 receiving amniocenteses, aspiration of turbid amniotic fluid that would not permit the reading of newsprint through it was associated with a lecithin/sphingomyelin (LS) ratio of greater than or equal to 2.0, or the presence of phosphatidyl glycerol (PG) in 97% (specificity 98%, positive predictive value 97%). The authors conclude that when turbid fluid is aspirated, delay until LS and PG results are known may not be necessary.

The effect of plasma from 34 patients with untreated Hodgkin's disease on the transformation of homologous normal lymphocytes was compared with that of plasma from matched normal control subjects. The plasma from some of the patients reduced lymphocyte responsiveness to phytohaemagglutinin (PHA) and this inhibitory effect was most obvious in plasma from patients with advanced-stage disease. In addition, the patient's own lymphocytes showed a depressed response to PHA, an effect also apparent to a greater degree in patients with advanced disease. This finding did not correlate with the numbers of available T-lymphocytes or the amount of unstimulated lymphocyte DNA synthesis, but did correlate with the observed plasma effects. It appears that impairment of lymphocyte transformation in Hodgkin's disease is in part due to soluble circulating inhibitory substances appearing as the disease progresses.