Helander I, Nordman E, Häkkinen I P, Toivanen A
Br J Dermatol. 1979 Oct;101(4):421-7. doi: 10.1111/j.1365-2133.1979.tb00020.x.
The immunological status of seven patients with disseminated melanoma during BCG scarification was followed. As parameters, the total peripheral blood leukocyte and lymphocyte counts, serum immunoglobulin levels, natural ABO blood group antibodies, lymphocyte responses in vitro to PHA and PPD, and skin reactivity against PPD and candidin were followed during a period of 2--36 months. The EAC-rosette-forming cells increased and the E-rosette-forming cells decreased during prolonged BCG therapy. The skin reactions and lymphocyte responses showed in most patients conversion from negative to positive or augmentation at the start of the therapy. Later on, however, the values in most patients dropped before disseminated disease became clinically apparent. In the only surviving patient the values first increased, remained high, and after 100 weeks treatment decreased. After 140 weeks' treatment immunological parameters are similar to pre-treatment levels. The possibility that prolonged intensive BCG treatment might eventually suppress the immune system, and thus result in an enhanced risk of dissemination of the disease, is discussed.
对7例播散性黑色素瘤患者在卡介苗划痕接种期间的免疫状态进行了跟踪观察。以全外周血白细胞和淋巴细胞计数、血清免疫球蛋白水平、天然ABO血型抗体、淋巴细胞体外对PHA和PPD的反应以及皮肤对PPD和念珠菌素的反应性作为参数，在2至36个月的时间内进行跟踪。在长期卡介苗治疗期间，EAC玫瑰花结形成细胞增加而E玫瑰花结形成细胞减少。在大多数患者中，皮肤反应和淋巴细胞反应在治疗开始时显示从阴性转为阳性或增强。然而，后来在播散性疾病临床显现之前，大多数患者的值下降。在唯一存活的患者中，这些值首先升高，保持在高位，在治疗100周后下降。在治疗140周后，免疫参数与治疗前水平相似。讨论了长期强化卡介苗治疗最终可能抑制免疫系统，从而导致疾病播散风险增加的可能性。
