APID PROGRESS IN ANY FIELD tends R temporarily to create confusion and eben chaos. Recent advances in immunologic aspects of disease have been no exception. In the past decade, we have acquired more new knowledge than our intellectual capacities and organizational talents have been able to absorb and integrate. Clinically, information has accumulated most rapidly in three broad areas of immimology, the areas where clinical immunology, rheumatology, and hematology overlap: ( I ) the immunologic deficiency \tates: ( 2 \ diseases of immunologic aberration;' and ( 3 ) neoplastic diseases of immunologically competent cells-i.e,, lymphoreticiilar malignancies. The failure to integrate this newly acquired information is evidenced by the marked controver-\ > over the etiology and pathogenesis of these three groups of diseases. This failure i< especially siirprising since the association of diseases of immunologic aberration ( D I 4 ) and lymphoma within the same tamilv, and indeed in the same patient, has heen noted with increasing frequency in the past decade.l:{ Similar associations have been noted between DIA and immunologic deficiencie~'*~-~ and between immunologic deficiencies and lymphomatous malignancies.1s7,h The simultaneous presence of immunologic deficiencies, DIA, and lymphomatous malignancies, then, would not be unexpected, as commented on previously.l The DIA most commonly seen with lymphoma is antibody hemolytic anemia. What is the significance of this finding?Our previous concepts of the mechanism responsible for this association were based on the assumption that somatic mutation of lymphoid cells often takes place but that the mutant cells are usually destroyed by the normal immunologic apparatus. Thus, -2656(12) *The so-called "autoimmune" diseases. Our group prefers the term "diseases of immunologic aberration" since it does not imply a cause-andeffect relationship between the various disease processes and the serologic factors characteristic of each. The evidence that these "autoantibodies" play an etiologic role in most of the disease entities termed "autoimmune" is, at best, sparse,