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December 3, 1982

Immunotherapy in Leprosy-Reply

Author Affiliations

Armed Forces Institute of Pathology Washington, DC

JAMA. 1982;248(21):2833. doi:10.1001/jama.1982.03330210025011

In Reply.—  We appreciate Dr Fusaro's discussion of research on the use of transfer factor in efforts to enhance the immunity of lepromatous patients.Our article cited the work of Hastings and Job,1 who treated four lepromatous patients and one borderline patient with transfer factor obtained from approximately 7.4×109 lymphocytes given in 36 divided doses during 12 weeks.Clinical reversal reactions (immunologic upgrading) were observed in the four lepromatous patients but not in the borderline patient.2 Histopathologically, skin biopsy specimens of the four lepromatous patients showed a reduction of acid-fast bacilli and proliferation of epithelioid and giant cells.In one lepromatous patient, the reversal reaction persisted 14 months after the injections were stopped. In two lepromatous patients, they continued to appear four to 28 months after the last transfer factor injection was given. In the remaining lepromatous patient, the reversal reaction continued five months after the last injection,