Australia Antigen (a Hepatitis-Associated Antigen) in Leukemia<xref ref-type="fn" rid="FN2">2</xref><xref ref-type="fn" rid="FN3">3</xref>

Abstract

Australia antigen [Au(1)] occurs in high frequency in patiente with leukemia and Hodgkin's disease; its frequency in the normal U.S. population is 0.1%. It is relatively common in patients with Down's syndrome and other chromosome abnormalities (increased incidence of leukemia). We previously reported transient Au(1) in acute viral hepatites; current evidence indicates that it might be a virus which causes much of the hepatitis in this country. The frequency of Au(1) in 688 leukemia patients is 7.0%, and in 80 with Hodgkin's disease, 6.3%. The frequency in acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), and acute myelogenous leukemia (AML) is 9.8, 6.7, and 9.0%, respectively, but only 2.7% in chronic myelogenous leukemia (CML). Au(1) was detected in 16 of 147 patients from whom serial samples were obtained. In 14, it was absent in the initial specimen. The relation of Au(1) to blood transfusion and other forms of therapy was studied in 512 patients; it was found to be associated only with transfusion. This study confirms an increased frequency of persistent Au(1) in patients with leukemia and Hodgkin's disease. The antigen is associated with preceding blood transfusions, but may occur without transfusion. Au(1) probably represents chronic anicteric hepatitis in leukemia patients. When compared with transfused nonleukemic patients, the frequency of Au(1) in transfused ALL and CLL patients is very high, while there is no significant difference in AML and CML. This favors the explanation that persistent infection results from immune defects in lymphocytic leukemias, but other mechanisms for this association are possible.