Preliminary evaluation of immunotherapy in patients with Hodgkin's disease.

The clinical course of 38 patients with Hodgkin's disease in the stage of remission was evaluated. The material consisted of two groups of patients: 1. submitted to immunotherapy and 2. control group. In 16 cases immunostimulation was performed with BCG vaccine, including four cases treated with BCG vaccine and levamisole and 3 patients were given levamisole only. In some patients, immunotherapy restored normal immunologic reactivity, as shown by the reversion of negative tests of delayed hypersensitivity. In all patients treated with levamisole caused normal blastic transformation of PHA-stimulated lymphocytes. In the group of patients treated with immunotherapy relapses of malignant lymphogranulomatosis were observed in 10.6% of cases, and in the control group--in 15.7%. The patients of both groups remain under continuous clinical surveillance.

Immune condition in patients with Hodgkin's disease.

In 40 cases of Hodgkin's disease (24 untreated patients and 16 patients in remission) the immunological humoral and cell-mediated competence was studied using test of hypersensitivity of DNCB and PPD, blastic transformation and the ability of 3H-DNA synthesis in lymphocytes stimulated with PHA and PWM, and in some cases, with PPD. In all patients the concentration of serum immunoglobulins was determined as well. Impairment of immunological reactivity was found in about 40% of patients, on the average, in various stages of the disease and during remissions following treatment with cytostatic agents and radiotherapy. The most frequent abnormality found in 52.5% of cases was impairment of blastic transformation of lymphocytes stimulated with PHA in vitro. In 60% of cases negative results of intradermal test with PPD and in 75% of patients the DNCB test was negative. No correlation could be found between impairment of the immune competence in this disease and the clinical stage and/or type of histological changes in lymph nodes.

Occurrence of malignant neoplasms in patients with chronic lymphatic leukaemia.

In a group of 280 patients with chronic lymphatic leukaemia, a coexistence of malignant tumours diagnosed simultaneously with the leukaemia was found in 14 cases or 5.0%. No significant difference was observed between the development of the second malignant neoplasm in the patients studied and the expected incidence in the general population, taking into account also the sex and age of patients and their place of residence. No statistically significant relation was found between the duration of CLL and the occurrence of second malignancies. No significant correlation was found between the total dose of cytostatic drugs, corticosteroids or radiotherapy and the incidence of cancer.

[To treat or not to treat chronic lymphocytic leukemias with a mild course?]. / Leczyc czy nie leczyc przewlekle bialaczki limfatyczne o lagodnym przebiegu

The study is based on a material of 60 patients with chronic lymphocytic leukaemia of mild course with survival over 4 years. The method used was a comparison of the patients treated from the time of diagnosis establishment with the group of similar patients not treated throughout the whole period of follow-up and with another group of patients treated from the time of exacerbation of the proliferative process. The following data were taken into account: survival length, degree of splenomegaly and lymphadenopathy, leucocyte and platelet counts, haemoglobin level, infectious complications. It was demonstrated that cytostatic and/or hormonal treatment started at the time of diagnosis establishment did not prolong the survival. A statistically significant prolongation of survival time was observed, on the other hand, in cases treated from the time of exacerbation. Cytostatic agents increased the risk of infections and the risk of thrombocytopenia.

[Course of chronic lymphatic leukemia in 2 age groups: older and younger patients]. / Przebieg przewleklej bialaczki limfatycznej w dwóch grupach wieku: starszej i mlodszej

The authors analysed 202 cases of chronic lymphatic leukaemia comparing the course of this disease in patients above and below 60 years of age. The observation included patients with various forms of this disease--with morphological and clinical findings compatible with mild disease and cases with severe course with complications. It was observed that in severe form of lymphatic leukaemia the course of the disease is similar in both groups of patients and the shorter survival of patients in the older group is frequently due to coexistence of other diseases impairing the general condition and changes connected age. On the other hand, a mild, oligosymptomatic course of the disease was observed more frequently in older patients who did not require intense treatment in hospitals.

[Clinical and pathological analysis of patients with chronic lymphatic leukemia and long survival]. / Analiza kliniczna i anatomopatologiczna chorych z przewlekla bialaczka limfatyczna o dlugim przezyciu

Investigations were carried out on 261 patients with chronic lymphatic leukaemia with survival over 4 years. The following problems were discussed: age and sex of patients, presenting symptoms, organ changes, laboratory investigations, infectious complications, coexistence of malignant tumours. Correlations were established between various parameters and the length of survival. It was demonstrated that patients without palpable lymph nodes and spleen at the beginning of the diseases and with leucocyte counts ranging from 10,000 to 100,000/1 mm-3 have a better prognosis, while thrombocytopenia even without haemorrhagic diathesis is a poor prognostic sign. Infections were observed in 50 percent of cases, more frequently in patients with hypogammaglobulinaemia. Coexistence of malignant tumours was found in 5.4 percent of cases. Pathological examinations including organ biopsy and autopsy failed to demonstrate characteristic features of lymphatic system proliferation as compared with patients with short survival.