Hematologic and immunologic status in Hodgkin's disease 5 years after radical radiotherapy

Abstract

The hematologic and immunologic status was evaluated after 5 years of continuously disease-free survival for 71 consecutive patients treated for Hodgkin's disease by radiotherapy. There was no evidence of residual hematologic depression, even in those patients treated initially with total nodal irradiation. Similarly, quantitative immunoglobulin levels were within the normal range, and the response to delayed hypersensitivity skin testing was intact in nearly all patients. These immunologic studies were consistent with the observed absence of an unusual incidence of infectious complications in these long-term survivors.

Follow-up studies on the immune status of patients with Hodgkin's disease after splenectomy and treatment, in relapse and remission

“…In patients with Hodgkin's disease studied 5 years after completing radical radiotherapy, no gross defects in immunity were found (Kun and Johnson, 1975). Short intensive courses of chemotherapy, whilst initially suppressing humoral and cellular immunity, may be followed by "rebound-overshoot" recovery (Serrou, Dubois and Silva, 1974;Harris et at., 1976) and even after prolonged continuous chemotherapy, immunity may be only slightly depressed or may even recover to normal (Chang, Stutzman and Sokal, 1975).…”

Immunity in Hodgkin's disease: status after 5 years' remission

“…The discrepancies between the increased total-lymphocyte and T-lymphocyte levels compared with depressed in vitro lymphocyte function in remission is difficult to explain and this is further complicated by reports of normal skin-test reactivity in other series (Kun & Johnson, 1975;Fisher et al, 1980). However, the non-concordance of the various methods of assessment of immunity is well recognized and it may well be that different aspects of the immunological system are variably affected by the therapeutic regimes being used or that such immune defects are peculiar to patients with Hodgkin's disease.…”

“…Cellular immunity may remain depressed for years after chemotherapy (Fisher et al, 1980) and after radiotherapy long-lived defects in cellular immunity may also be found (Fuks et al, 1976;Bjorkholm et al, 1977b), though Kun & Johnson (1975) found normal delayed hypersensitivity skin-test responses 5 years after radical radiotherapy. Impaired humoral immunity has been observed in treated Hodgkin's disease (Weitzman et al, 1977); however, other reports (Fisher et al, 1980;Kun & Johnson 1975) suggest that in the longterm humoral immunity is not depressed. In 1977 we reported our early follow-up studies on the immune status of patients with Hodgkin's disease after splenectomy and treatment (Hancock et al, 1977).…”

Immunity in Hodgkin's disease: status after 10 years remission

“…Bjorkholm et al (1977a, b) also demonstrated persistent defects 15-18 months after radiotherapy, and in a group of nine cured patients 10-28 years after treatment. However, Kun and Johnson (1975) were unable to show any evidence of residual haematological or immunological depression in 71 patients treated successfully by radiotherapy for their Hodgkin's disease 5 years previously.…”