“…In addition, impaired lymphocyte transformation has been ob served in diseases involving immunological disorders, as in ataxiatelangiectasia [46,68,77], agammaglobulinemia [9], Sjogren's syndrome [47], congenital absence of the thymus [22,44,50] and thymic dysplasia [29,56]. The available evidence strongly indicates that the in vitro lymphocyte transformation is related to the cellular immune reactions, particularly to the delayed hypersensitivity [8,21,29,43,60,69], although a recent report offers evidence indicating that it is related to both cellular and humoral immune reactions [12]. The exact relationship of the mitogenic effect of a non-specific stimulant such as the phytohemagglutinin to the immune reactions is not under stood, but the fact that impaired response is observed in diseases with immunological disorders suggests the possibility that its impairment in Down's syndrome may also be related to some immunological defect.…”