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Delayed-Type Hypersensitivity and the Immunology of Hodgkin's Disease, with a Parallel Examination of Sarcoidosis

Laboratory of Immunology, The Rockefeller University, New York, New York

A critical evaluation of studies made on Hodgkin's disease is given with respect to anergy and its implications, based on present immunologic understanding. The sources of patients and the types of tests are tabulated, the small numbers studied hardly warranting the usual custom of expressing findings as percentages. Comparison is made in several areas, by tabulation of sources with parallel information secured in studies on sarcoidosis, another disease exhibiting anergy but lacking the progressing anergy of Hodgkin's disease. The parallelisms existing between these 2 unlike diseases, one nonneoplastic, are striking.

The apparent capacity of Hodgkin's patients to reject adoptive transfer of delayed type sensitivities is discussed at length in the light of current immunologic knowledge, particularly as to possible mechanisms of such an effect and its implications for the anergy of the subjects.

Method currently being studied for evaluating normal responses of lymphoid cells in vitro and in vivo—often with experimental animals—are outlined; some of these methods are being adapted to studying the limited capabilities of lymphoid cells in patients with Hodgkin's disease or sarcoidosis.

Studies on antibody synthesis by patients with Hodgkin's disease or with sarcoidosis are reviewed in detail, and the capacity to respond to antigenic stimuli is likened to the differential effect of X-irradiation on primary and secondary immunologic stimuli given to rabbits.