Correlation between immune complexes and prognostic factors in Hodgkin's disease.

Serum or plasma samples from sixty-two patients with Hodgkin's disease (HD) were tested by four assays for circulating immune complexes or complement activation products: macromolecular C3 (MMC3), I-labelled C1q binding (C1qBA), conglutinin binding (KgB) and plasma C3d levels. There was good agreement between the C1qBA, MMC3 and plasma C3d assays, and each gave significantly higher proportions of positive results in patients with symptoms of fever, night sweats and weight loss. The much lower proportion of positive assays by KgB, one out of thirty-three (3%) in asymptomatic and six out of twenty-nine (21%) in symptomatic patients, may reflect an inherent property of complexes or the presence of an inhibitor of conglutination in HD serum. A positive result in one or more of these assays occurred in twenty-six out of twenty-nine (90%) of symptomatic patients compared with only ten out of thirty-three (30%) in asymptomatic patients. Most of the positive tests in the asymptomatic groups were by the C1qBA, and with one exception, these were from patients with histological types carrying a poor prognosis. In patients with poor prognostic histology, although the MMC3 and C3d assays detecting complement activation correlated with the symptoms, this was not found for immune complexes detected by the C1qBA. The close correlation between positive tests and two features known to adversely affect the prognosis in HD indicates that the detection of immune complexes may be of use in the staging and management of patients with this disease.