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The rates of B and T-cell-subpopulations of lymphocytes were examined on 15 children with acute lymphatic leukemia during the first complete remission under maintenance in the Pinkel VII scheme and in 6 further cases with modification of this scheme of treatment compared to normal children in the same age groups. Further on 4 children during a relapse, on 1 during the second remission, and on 3 during long-term remissions. The most important result was a significant reduction of B cells during intensive maintenance therapy of the Pinkel scheme. In the few cases of long-term remissions a reduction of B cells was no longer observed.

Eleven patients with stage-III cancer of the cervix were investigated before, during and after radio-therapy in regard to their state of humoral immunity on the basis of determinations of the serum IgG, IgM and IgA concentration, of hetero- and isoagglutinins, of tetanus antitoxin before and after vaccination with toxoid, of measles antibodies and of the percentage of lymphocyte membrane fluorescence. The cellular immunity of the same patients was investigated by determination of the percentage of spontaneously-rosetting lymphocytes, of skin-test reactivity with DNCB before and after sensitization, of skin-test reactivity with candida, trichophyton, varidase, OT and staphylo antigen. The function of polymorpho-nuclear leucocytes was investigated by means of the NVT test and St. aureus, E. coli and latex particles. All investigations were performed both before, and 3, 6, 9 and 12 weeks after the commencement of radiotherapy and the results were compared with those of an operated, non-irradiated group (stages I b and II a). Two types of noteworthy results were observed: 1. A decrease in immunological reactivity, probably in connection with cancer, since this reaction was observed both in irradiated and in non-irradiated cases, characterized by lowered or absent immune answer to tetanus toxoid, lymphopenia, decrease in sensitization to DNCB and less positive skin tests to old tuberculin and varidase. 2. An additional inhibition (although in one investigation stimulation of the immune answer was also seen), probably in connection with radiotherapy, characterized by an additional decrease in immune answer to tetanus toxoid, in skin sensitivity to DNCB sensitization and in tests with old tuberculin, and an augmented lymphopenia, as well as an increase in positive skin tests with varidase. No significant changes were observed with any other method.

The immunological reactivity of 19 operated cases of breast cancer (14 T1 2, 5T3) was investigated before and at 3-weekly intervals up to 12 weeks after radiotherapy by means of a large panel of techniques. The results were compared with two groups of identically-investigated patients, one consisting of 11 cases of cervical cancer (stage III), treated solely by irradiation and the other of 12 cases of cervical cancer (Stages I a and II b), treated by operation only. Before irradiation and in the non-irradiated group cellular immunity appeared to be more disturbed in cases of breast cancer than in cases of cervical carcinoma, as shown by the lowest number of lymphocytes, the lowest number of spontaneously-rosetting lymphocytes, the lowest percentage of DNCB sensitization in patients and the lowest percentage of Tuberculin-positive skin tests. In both types of carcinoma the humoral immunity appeared to be impaired, as apparent from the lowered immune response to tetanus vaccination. Other parameters of humoral immunity such as the immune globulin concentration, iso- and heteroagglutinine, the titre of measles antibodies or membrane fluorescence of lymphocytes showed no dinstinct trends during the investigation period. After irradiation a) inhibiting and b) stimulating influences were observed: a) The incidence and extent of the immune response to tetanus vaccination was further reduced and a distinct lymphopenic effect was observed. b) The incidence of positive skin tests with varidase, as well as the number of spontaneously-rosetting lymphocytes increased after the commencement of irradiation. Apart from the known sensitization with DNCB and skin tests with tuberculin, determination of the antitoxin titre before and after tetanus vaccination provided the most reliable results in regard to immunological reactivity in the investigated tumour patients.

12 patients were investigated in regard to their state of humoral immunity by means of the following determinations: IgG, IgM, and IgA concentrations in the serum, hetero- and isoagglutinins, tetanus antitoxin before and after immunization with toxoid measles antibodies and the percentage of lymphocytes with membrane fluorescence. The cellular immunity was investigated in some patients with determination of the percentage of spontaneously-rosetting lymphocytes, of the DNCB skin-test reactivity before and after sensitization with DNCB and of skin-test reactivity to candida, trichophyton, varidase, OT and staphylo antigen. The functional efficiency of polymorphonuclear leucocytes was investigated by means of the NBT test and Staph. aureus, E. coli and Latex particles. All investigations were performed before, and 3, 6, 9 and 12 weeks after surgery. 4 methods only amongst the entire spectrum employed in the investigation proved to give sufficient evidence of signs of decreased efficiency of the immune response in the investigated patients: determination of tetanus antitoxin before and after immunization, a distinct increase in titre being observed only in 5 cases, determination of the sensitization to DNCB, which was positive only in 4 cases and determination of skin-test reactivity to varidase and OT, which was found to be less frequently positive than in controls. However, all these reactions showed no evidence of any correlation to surgical management and appeared merely to reflect characteristic responses of these cancer patients. Moreover, with the exception of the decrease in lymphocytes, no changes were detected in the data obtained by the other methods used in this study which might show some reflection of an alteration in response following surgery.