Sex as a Factor I N the Prognosis of Hodgkin’s Disease

Physicians have long recognized that malignant lymphogranulomatosis, or Hodgkin’s disease, occurs but one-third as frequently in women as it does in men. In the course of a previous study (1) it was noted that not only was this condition less common but that it also appeared to be less malignant in the female sex. As this was merely an impression, however, the literature was reviewed for statistical evidence bearing on this point. Gemmell (2) in 1923 was impressed by the fact that Hodgkin’s disease occurs less frequently in women but did not realize that its severity is also lessened. He studied 5 7 cases in females, gathered from the literature and from his own experience, and pointed out that the patients usually showed varying degrees of oligomenorrhea up to complete amenorrhea. Of 10 parous patients, 6 dated the onset of their disease from a pregnancy. In approximately half of the series the disease was first observed during a period of physiological amenorrhea-in 10 cases before puberty, in 8 after the menopause, in 5 during pregnancy, and in 2 during lactation. Gemmell recorded post-mortem studies on four patients, one of whom showed marked atrophy of the genital organs despite the fact that she was but thirty-one years of age. Others have reported similar cases, as exemplified by the twenty-two-year-old patient described by McAlpin and Von Glahn (3). As a result of his studies, Gemmell postulated that ovarian function furnishes a relative protection against the inroads of Hodgkin’s disease.