Autoimmune neutropenia in Hodgkin's disease

A patient was profoundly neutropenic at the time of diagnosis of stage IIIB Hodgkin's disease. The neutropenia was not due to infection or bone marrow involvement by tumor. It did not respond to discontinuation of medication or to splenectomy, done for pathologic staging of Hodgkin's disease. The patient's serum contained abnormally increased granulocyte-binding antibody, which reacted with his own cells. The neutropenia resolved with high-dose prednisone therapy, and has not recurred after chemotherapy. Thus, immune neutropenia--as well as autoimmune hemolytic anemia and immune thrombocytopenic purpura--can be associated with Hodgkin's disease. Recognition and treatment of such immune processes assume major importance in planning cytotoxic therapy for the underlying malignancy.