Immunologic evaluation in the prognosis of acute lymphoblastic leukemia. A report from Childrens Cancer Study Group.

Eight-hundred ninety-five previously untreated acute lymphoblastic leukemia (ALL) patients were entered on a protocol designed to provide results of selected immunologic tests. At diagnosis, delayed hypersensitivity tests with four antigens (tetanus, diptheria, candida, and SKSD), immunoglobulin levels, tests for serum inhibition to phytohemagglutinin-stimulated lymphocyte blastogenesis, and HLA-A, B, and C typing were performed. Although delayed lymphocyte blastogenesis have been reported previously to be abnormal in ALL, we did not find them to be associated with disease outcome. Thirty percent of the patients had reduced levels of one or more immunoglobulins. The frequency of remission was less in those patients with decreased IgG and IgA. IgA and IgM showed prognostic importance in remission duration, and all three fractions appeared to have prognostic significance for survival duration. Although none of the HLA types appeared to be associated with significantly increased or decreased success in remission induction, patients with antigens A28 or B12 and patients bearing lymphocyte A11/B35 had shorter remissions. our results indicate that the immunologic factors studied, hypogammaglobulinemia and certain HLA antigens may be related to disease control and outcome in ALL.

HLA-A2 antigen in schizophrenic patients with reversed cerebral asymmetry.

The frequency of HLA-A2 was examined in 32 black and 22 white schizophrenic patients separated into two groups according to whether they had normal or reversed cerebral hemisphere asymmetries as determined by computed tomography. The black patients with reversed asymmetry had a significantly greater frequency of HLA-A2 as compared to black patients with normal asymmetry and a black normal control group. There were no significant differences for any other A, B or C antigens. These findings also held when only the 22 black patients without evidence of brain atrophy were studied. The results for the white patients were in the same direction but did not reach statistical significance. These findings suggest that, at least for black schizophrenic patients, reversed cerebral asymmetry is associated with an increased frequency of HLA-A2.

HLA antigens in schizophrenia:differences between patients with and without evidence of brain atrophy.

A survey of 14 published studies found no consistent association between specific HLA antigens and schizophrenia. Since these studies lacked diagnostic or biological criteria, an investigation was undertaken using recognized diagnostic criteria and CT scan findings. Typing for HLA antigens at loci A, B and C was carried out on 130 patients. Among 92 black schizophrenic patients there was an increase of HLA-A2 which remained significant even after correcting for the number of antigens studied. When the patients for whom CT scans were available were divided according to the presence or absence of evidence of brain atrophy, there was an increase of A2 in the black schizophrenic patients without evidence of atrophy, which remained significant after multiplying by the number of antigens studied. However, there was no significant increase of A2 in those with evidence of atrophy. Similar trends held for the white population but they failed to reach significance. The need for HLA studies on biologically defined groups of schizophrenic patients is stressed.

Human leukocyte antigen system not closely linked to or associated with bipolar manic-depressive illness.

An association and linkage study of the HLA system and bipolar affective illness is reported. HLA B-14 showed an increased frequency and HLA-Bw27 a decreased frequency in 92 bipolar patients compared to 210 controls, but significance is not reached when appropriate statistical corrections are made. It is shown that ethnological differences can lead to sampling biases; a purported increased frequency of HLA-Bw 16 in Ashkenazi Jewish bipolar patients is negated when ethnologically similar controls are used. The transmission of HLA alleles in nine families with at least two generations of affective illness revealed independent assortment, and nonlinkage to either locus A or B was demonstrated using a multigenerational method of linkage analysis. The nonreplicability of the HLA association studies, and the failure to demonstrate linkage of the HLA loci with afe development of affective illness, although further analyses are necessary.

HLA-B8 and dermatitis herpetiformis in patients with IgA deposits in skin.

The association between antigens of the HLA system and dermatitis herpetiformis (DH) using in vivo-bound IgA as an added criteria for diagnosis is reexamined. Twenty-eight of 33 (85%) immunologically proven patients with DH were HLA-B8 positive, whereas only 17 of 92 (18%) controls were HLA-B8 positive.

Naturally occurring human antibody to neuraminidase-treated human lymphocytes. Antibody levels in normal subjects, cancer patients, and subjects with immunodeficiency.

Antineuraminidase-treated lymphocyte antibody levels in normal individuals were compared to levels in patients with newly diagnosed malignancies, patients with immunodeficiency syndromes (some of whom subsequently developed cancer), and normal and affected members of multiple malignancy families. No correlation between antibody level and the presence of malignancy was found. In normal individuals, antibody levels were high in childhood and declined with advancing age in accord with behavior of other natural antibodies.