IMMUNOGLOBULIN LEVELS AND LYMPHOCYTE-RESPONSE TO MITOGENIC STIMULATION IN CHILDREN WITH MALIGNANT DISEASE DURING TREATMENT AND FOLLOW-UP

Intensification of chemotherapeutic regimens has improved survival in childhood malignant disease. To characterize the impact of this intens ified therapy on some aspects of the immune system, we have, in an uns elected material of 220 children with malignant disease, investigated serum immunoglobulin levels and lymphocyte response at diagnosis and t hen subsequently during and up to 4 years after cessation of therapy. In leukemia and Hodgkin's disease, all immunoglobulin isotypes decreas ed during therapy. A profound depression of immunoglobulin M levels, l asting well after completion of therapy, was seen in all tumor types. The mitogenic response was attenuated in patients with leukemia at dia gnosis but was rapidly restored after institution of therapy. Patients with solid tumors, particularly Hodgkin's disease, had a reduced mito genic response during therapy. Thus these patients exhibit multiple im munological disturbances. The basis of the pronounced immunoglobulin M deficiency remains unclear.