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Competing Interests: Details of contributions of authors and acknowledgments are in the appendix (p 6). CPF receives consultancy fees from AstraZeneca (not related to vaccines) and participates in an advisory board for AstraZeneca (not related to vaccines). MA receives research funding from Pfizer (not related to vaccines), GPC receives research funding from Pfizer (not related to vaccines) and participates in advisory boards for AstraZeneca and Pfizer (not related to vaccines). AJD reports receiving research funding and honoraria from AstraZeneca and Janssen (not related to vaccines). DG receives support from the NIHR Great Ormond Street Biomedical Research Centre All other authors declare no competing interests.

The number of survivors having undergone high-dose therapy (HDT) followed by auto-SCT continues to increase, although some of the long-term sequelae remain incompletely understood. The immunological status and quality of life of 37 HDT/auto-SCT survivors with lymphoma in continuous remission of ≥3 years were assessed alongside 14 age-matched controls. At a median follow-up of 10.5 years (range 2.2-20.2) following HDT/auto-SCT, the proportion of CD4(+) cells remained significantly reduced in patients compared with controls (median 43.4% vs 62.5%, respectively; P = < 0.001), predominantly a result of sustained reduction in the naive CD4(+) component (P < 0.001). Naive CD8(+) lymphocytes (P = 0.014) and transitional B cells (P = 0.008) were also significantly reduced, but differences in other lymphocyte subsets were not observed. Uptake of revaccination following HDT/auto-SCT was sporadic; between 11% and 33% of patients had serological titres outside the protective ranges for five of six routinely used vaccines. In the main, patients were found to have a good quality of life, although their EORTC QLQ-C30 questionnaire scores were significantly lower for the physical and social functioning domains compared with controls. Ten years after HDT/auto-SCT immunological deficits persist; to avoid excess risk of preventable disease, serological immunity should be assessed post HDT/auto-SCT followed by appropriate revaccination.

The binding of horseradish-peroxidase-labelled peanut lectin (HRP-PNL) to cryostat sections of tonsil, lymphoma lymph nodes, reactive lymph nodes and miscellaneous tumours demonstrated that PNL binds selectively to lymphocytes in germinal centres. Lymph nodes from 21 patients with non-Hodgkin's lymphomas were phenotyped as cell suspensions for PNL binding, and the following surface markers: E rosetting, C3d, SIg, OK markers of T-cell subsets, Ig heavy-chain and light-chain classes. There was a positive correlation between PNL binding and cells with SIg and C3d receptors. 4/5 cases of centroblastic/centrocytic follicular lymphoma had a PNL+ SIg+ C3d+ phenotype. Both cases of centroblastic/centrocytic diffuse lymphoma were PNL-. There was no correlation between PNL binding and heavy- or light-chain Ig class. PNL binding and presence of C3d receptors were not always positively correlated, indicating that follicular cells may be either PNL+ SIg+ C3d+ or PNL+ SIg+ C3d-. The binding pattern of PNL to 1 case of thymic hyperplasia and 2 cases of malignant lymphoma lymphoblastic T type suggested that some but not all cortical thymocytes bind PNL.

The lymph node cell populations from 24 patients with non-Hodgkin's lymphoma were investigated for some of the surface characteristics which are used as T- and B-lymphocyte markers. Nineteen of the patients had had no treatment of any kind while the other 5 had had either recent radiotherapy or chemotherapy. Seven lymph nodes from patients without malignant disease and 7 others with reactive changes were also studied. It was found that lymphocytic lymphomas, nodular or diffuse, well or poorly differentiated, had a high proportion of cells which were positive for B-cell markers. Other non-lymphocytic lymphomas had a higher proportion of cells positive for T-cell markers, and were similar to the cells from non-malignant lymph nodes.

The discovery of B or T markers on neoplastic cells in acute lymphoid leukemia (ALL) is correlated with a poor prognosis, while a cure expectancy of 50% can be expected for null cell ALL patients of all ages. In the case of Non Hodgkin's malignant lymphoma the patients with the T cell types carry a poor prognosis, while the patients with a B cell type present an 85% cure expectancy, and those with the null cell type a 65% cure expectancy. The correlation between immune markers on the one hand, and WHO cyto-histological typing and clinical presentation on the other, is reported.