Effects of locally applied cortisone acetate on delayed hypersensitivity reactions in cancer patients.

Abstract

Delayed hypersensitivity reactions (DHR) are known to be markedly suppressed in patients with malignant diseases. Corticosteroids have been shown to depress DHR. In sarcoidosis, however, in which DHR to tuberculin antigen is impaired, local application of cortisone with PPD changed skin reactions from negative to positive in 50% of the patients. Two hundred and fourteen patients with advance nonhematological neoplastic diseases were tested for purified protein derivative (PPD) sensitivity and 174 to mumps antigen. At the same time, local effect of cortisone was tested on these reactions. Twenty patients (9.3%) had positive PPD tests and 24 (13.8%) had positive reactions to mumps antigen. After adding cortisone acetate to the tested antigens, 6 patients changed from a negative to positive reaction to PPD, and one patient changed from negative to positive with mumps antigen plus cortisone. This suggests that in some cancer patients, the impaired DHR may be due to a block at the peripheral site and, further, that such a block could be removed by local cortisone.