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In order to clarify the mechanisms of the eosinophilia frequently observed in patients with Hodgkin’s disease (HD), 18 patients and 16 age- and sex-matched controls were studied. Increased eosinophil numbers in peripheral blood and serum IgE, as well as decreased cell-mediated immunity were present in HD patients compared with control individuals. Advanced disease was accompanied by lower eosinophil levels, increased IgE, and lower CD4+ T cell counts in peripheral blood. Eosinophilia correlated with CD4+ T cell counts, suggesting that eosinophil production could be under CD4+ T cell control. GM-CSF production in vitro by Phytohemaglutinin-stimulated mononuclear cells was significantly lower in HD patients with eosinophilia. On the other hand, an eosinophil-survival-enhancing activity was found in sera and culture supernatants from controls and HD patients; this activity was stronger for HD patients and was higher for those with eosinophilia. Furthermore, this activity was completely abolished by preincubation with monoclonal antibodies to IL-5, but not with normal mouse serum. Our results suggest that defects of cell-mediated immunity present in patients with HD are accompanied by a predominant type 2 cytokine profile. IL-5 is involved in the increased eosinophil production observed in these patients.

Twenty-five patients with Hodgkin's disease and high eosinophil counts were observed for an average of 90 months. Fluctuations in the levels of eosinophils were important in the course of observation. No relation with stages, histologic type, or evolution was noticed. Steroidcontaining regimens and severe premortem conditions seemed to lower the counts. Relapse-free survival was shorter in our 25 patients than in a control group of 50 patients with Hodgkin's disease and no eosinophilia who had approximately the same stage, histologic type, and treatment of disease. However, the overall survival was somewhat better for the eosinophilic patients with stages IIIB and IV (0.1 > P > 0.05). Cancer 1992; 691248-1253.Blood eosinophilia in cancer is an uncommon phenomenon found in a relatively small number of cases.' Hodgkin's disease (HD) is an exception, being the malignancy in which eosinophilia occurs at a frequency of approximately 1570. ' The association of HD with tissue eosinophilia was known some years before Dorothy Reed described the cells that now bear her name and before she reported the presence of numerous eosinophils in the tissues.3r4 Although blood eosinophilia in HD was reported more than 50 years ago by some a~t h o r s ,~,~ the finding was not considered significant.' However, a recent article7 reports a better survival rate of patients with HD and blood eosinophilia.The current study reports the follow-up of 25 cases of HD with blood eosinophilia during an average of 90 months.

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