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Serum Immunoglobulin E Levels in Patients with Neoplastic Disease

From the Metabolism Branch and the Medical Oncology Area, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20014

Abstract

The serum immunoglobulin E (IgE) concentrations of groups of patients with neoplastic disease were determined with a double antibody radioimmunoassay technique. The IgE levels were normal in patients with most of the types of neoplastic disease studied. However, the serum levels of IgE were reduced in patients with neoplasms affecting the B cell (thymic independent) system of lymphocytes and plasma cells. Thus, the geometric mean serum IgE concentrations of patients with chronic lymphocyte leukemia (18 ng/ml), multiple myeloma with an IgG paraprotein (27 ng/ml), and multiple myeloma with an IgA paraprotein (36 ng/ml) were significantly reduced (p < 0.05) below the geometric mean of normal controls (96 ng/ml). The reduction in IgE levels is a feature of a more generalized pattern observed in these patients of reduced polyclonal immunoglobulin synthesis and reduced numbers of B lymphocytes bearing normal polyclonal surface immunoglobulins. This reduction in the number of normal B lymphocytes and in the concentration of polyclonal immunoglobulins may be due to the production, by the malignant plasma cells and lymphocytes, of humoral regulators of B cell proliferation and immunoglobulin synthesis.

In contrast to these findings in patients with malignancies of the B cell system there was a 9-fold elevation of the geometric mean serum IgE concentration to 945 ng/ml in patients with Hodgkin's disease, a disease associated with abnormalities of cellular immunity and disorders of T cell function. It is suggested that a reduction of thymic dependent, T cell, regulators of IgE synthesis may occur in such patients and that this reduction in T cell regulatory function may be the cause of the high IgE levels seen in patients with Hodgkin's disease.

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