[Delayed-type skin reaction in children with malignant diseases]

The delayed type hypersensitivity reaction has been employed in order to study the cell-mediated immunity in 103 children and adolescents with malignant tumors, using the Multitest system (Mérieux). This skin test allows the simultaneous application of seven various recall-antigens in a standardized fashion and proved to be very predicative in normal children and adolescents at the age of 1-30 years, since beyond infancy no major variations of the test results has been observed in older age groups and a complete anergy has only been seen in 1.8%. The tumor patients were divided in three groups (50 patients with leukemia and malignant lymphoma, 23 patients with malignant bone tumors and 30 patients with other malignant diseases) and studied at the beginning or under chemotherapy. A significant decrease of skin reactions or a total anergy were found in all tumor groups compared to the normal control group and regardless the duration of chemotherapy. This was more pronounced in patients with systemic malignancies than in solid tumors. The largest group of the ALL- and NHL-patients showed a severely depressed cell-mediated immunity or complete anergy at the beginning of chemotherapy and subsequently improved already during the induction phase of chemotherapy. If improvement was missing, it was highly suspicious for relapse. In addition, such an increase of skin reactivity could not be demonstrated in few relapse patients during reinduction therapy. Patients with malignant bone tumors did not show such a dramatic depression of cell-mediated immunity at the beginning of chemotherapy and the results correlated with the course of the intervall chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)