Thymus-derived lymphocytes in patients with solid malignancies

Evaluation of adenosine deaminase activity in patients with head and neck cancer

ADA is a key enzyme in the mammalian purine salvage pathway. The lack of ADA activity has been linked to a lack of cellular immunity in various immune and myeloproliferative disorders. Data on its role in patients with solid tumors are scant and inconclusive. In this report, we have evaluated the activity of this enzyme in the peripheral lymphocytes of patients with head and neck squamous cell cancer (HNC). The mean ADA activity in Stage IV patients (0.57 +/- 0.08 SEM, n = 12) was significantly lower than that of controls (1.55 +/- 0.25 SEM, P less than 0.05, n = 14) and also significantly lower that the mean ADA activity in patients with Stages I, II, and III (1.14 +/- 0.10 SEM, P less than 0.05, n = 17). Fourteen out of 19 controls, Stage I, II, and III patients had positive skin tests compared to 7 out of 10 Stage IV patients. These differences were not statistically significant. There was also no correlation between ADA activity and the absolute lymphocyte counts. Our results indicate that ADA activity in lymphocytes of patients with advanced HNC is lower than that of controls or patients with earlier stages of the disease. ADA may be a more sensitive indicator of suppressed cellular immunity than delayed cutaneous hypersensitivity reactions, or monitoring absolute lymphocyte counts.

In vivo and in vitro observation of cellular immune parameters in squamous cell carcinoma of the oral cavity and its correlation with tumor load and prognosis

In vivo and in vitro observations of cellular immune response in 70 patients with squamous cell cancer of the oral cavity and in 40 age-matched normal controls, were made using delayed hypersensitivity responses to DNCB, PPD, and Candida albicans extract (Dermatophytin 'O'), absolute lymphocyte counts, absolute T-cell numbers, and PHA-induced lymphocyte blastogenesis reactions as parameters. The results were correlated with clinical stage, tumor size, lymph node involvement, tumor differentiation, lymphoreticular responses, and outcome during a one-year follow-up period. A significant degree of impairment of both in vivo and in vitro parameters was found in oral cancer patients compared to normal control. The impairment was more prominent in advanced stages. Lymph node involvement was associated with impaired dermal hypersensitivity to recall antigens as well as a reduced T-cell population and blastogenic response. Only delayed hypersensitivity response to DNCB, PPD, and Candida showed a correlation with histologic features such as tumor differentiation and lymphoreticular response. Although absolute lymphocyte counts and T-cell population were reduced in the primary stage of the disease, the functional capacity of isolated lymphocytes to undergo blast formation was retained. PHA-induced lymphocyte blastogenesis showed a significant impairment only when the tumor was well established and disseminated beyond its local confines. Delayed hypersensitivity responses to DNCB, higher T-cell counts, and blastogenic indices were associated with recurrence-free survival. Immunologic parameters provide prognostic information beyond the clinical stage of the disease. Therefore, it seems that a multiparametric in vivo and in vitro observation of cellular immune response may be useful as an indicator of clinical course and prognosis of patients with squamous cell cancer of the oral cavity.

Rationale for a novel immunotherapy of cancer with allogeneic lymphocyte infusion

A simple method of cancer immunotherapy has been developed which achieves marked objective response in 20-30% of patients with disseminated disease. Each course consists of a low dose of chemotherapy followed two days later by intravenous infusion of allogeneic lymphocytes. Courses are repeated on a monthly basis as needed. The function of the chemotherapy--too mild to significantly influence tumor growth directly--appears to be depletion of suppressor T cells, which sensitizes the patient to the immunostimulant action ("allogeneic effect") of the subsequently infused lymphocytes. The rationale for this method is discussed in the context of a review of past attempts at lymphocyte immunotherapy. We are now attempting to improve response rates by combatting anergy with nutritional immunopotentiators, and by preventing prostaglandin-mediated or -dependent immunosuppression with prostaglandin synthetase inhibition. By understanding and counteracting the various specific and general means by which a growing tumor induces host tolerance, it should prove possible to achieve immune-mediated tumor regression in a high proportion of patients. Best results may be seen when allogeneic lymphocyte therapy is initiated at an earlier stage of the disease, and is used in conjunction with surgery, radiotherapy, short-course intensive chemotherapy, or hyperthermia-based methods.

Interferon activity and its characterization in the sera of patients with head and neck cancer

The interferon (IFN) assay of the sera from the 40 patients with head and neck cancer was performed by the plaque-reduction assay with vesicular stomatitis virus in FL cells derived from human amniotic membrane. The patients mainly had Stage III or IV lesion without distant metastasis, and previously had not received any cancer therapy. All of the patients were histologically diagnosed as squamous cell carcinoma. When the serum IFN activity was characterized by acid treatment, significant increases of IFN-alpha/beta/gamma (n = 24, P less than 0.05) and acid-labile IFN (n = 24, P less than 0.001), and significant decrease of acid-stable IFN (n = 24, P less than 0.001) in the cancer patients of 50-to-79-year age group were found, as compared with those in the normal controls of the same age group (n = 20). When IFN titers including various immunologic parameters of the patients and normal controls were simultaneously assayed prior to the beginning of the cancer therapy, the titers of IFN-alpha/beta/gamma, acid-stable IFN, and acid-labile IFN were significantly correlated with some immunologic parameters such as natural killer (NK) activity, the absolute number of T gamma lymphocytes, the percentages of beta- and gamma-globulin, and the amounts of IgA, IgG, IgM, and beta 2 microglobulin. To define further the nature of this IFN, both sera of the patients and normal donors of 50-to-79-year age group were characterized by a neutralization assay with an antiserum to HuIFN-alpha and HUIFN-beta. The IFN activity left when the testing sera were neutralization with these antisera was expressed as gamma-like IFN. The titers of gamma-like IFN in the sera of patients (n = 24, P less than 0.0001) showed a highly significant increase as compared with the normal controls (n = 20). When the correlation between prognosis of the disease and titers of serum IFN were investigated by measuring gamma-like IFN and acid-stable IFN in the sera of patients, all of nine patients with good prognosis after the cancer treatment showed significant decreased levels of gamma-like IFN (P less than 0.01) and acid-stable IFN (P less than 0.05) as compared with those on the time before cancer therapy. On the other hand, titers of gamma-like IFN in the sera of six patients with recurrent disease showed a significant increase as compared with those on the IFN measurement before cancer therapy (P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

Transfer factor in restoration of cell mediated immunity in lung cancer patients

We studied the transfer factor (TF) with regard to in vivo and in vitro restoration of cell mediated immunity (CMI) in lung cancer patients. Twenty-eight lung cancer patients who had undergone resection were the recipients and 30 household contact family members with a positive reactivity to lung cancer extract were the donors of TF. Immunologic status was evaluated by delayed type cutaneous hypersensitivity (DTH), peripheral T lymphocyte number, PHA lymphocyte blastogenesis, serum blocking activity (SBA) and leucocyte adherence inhibition (LAI) test. When TF was administered twice subcutaneously to the patients, there was a statistically significant restoration or augmentation of DTH, PHA lymphocyte blastogenesis and abrogation of SBA, particularly in patients with suppressed CMI. These results suggest that it was the TF obtained from relatives of lung cancer patients with positive reactivity to tumor associated antigens restored or augmented tumor specific and nonspecific CMI in these lung cancer patients.

Immunology and oral cancer

This paper summarises the evidence for the involvement of the immune response in the development of neoplasia, discusses the immunological abnormalities found in patients with head and neck carcinoma, and outlines recent attempts at treatment of patients with head and neck carcinoma by modulation of the immune response (immunotherapy).

Immunobiologic staging of patients with carcinoma of the head and neck

For decades immunologic deficiencies have been documented in patients with carcinoma, and many investigators have attempted to utilize this information in determining prognosis more accurately. Determining prognosis more accurately would be most helpful with Stage III patients, since at present there are no useful guidelines as to which Stage III patients would benefit from aggressive surgery and/or radiation therapy and which would not. Assays of cellular immunity--such as skin testing, determining peripheral T-lymphocyte counts, and assessing lymphocyte reactivity--have achieved extremely limited clinical application. These assays are too expensive and/or too difficult to perform in the routine clinical setting. Total lymphocyte counts, however, are readily available in the clinical setting and can be helpful in determining prognosis. Other readily available clinical information, such as age and pretreatment serum immunoglobulin levels, can also be of value in determining prognosis. In this study, logistic regression was utilized to determine the prognostic implications of stage, age, and pretreatment total lymphocyte counts in 132 patients with carcinoma of the head and neck. Although each variable determined prognosis accurately less than 70% of the time, the stage, age, lymphocyte prognostic index (SALPI) accurately predicted outcome at 3 year follow-up 80% of the time (Pr. less than .0001). Discriminant function analysis was utilized to determine the prognostic implications of pretreatment serum immunoglobulins in 243 patients with head and neck carcinoma. A serum immunoglobulin prognostic index (SIPI) was derived which was based on the observations that elevated levels of immunoglobulin A (IgA) indicated a poor prognosis, while elevated levels of immunoglobulin E (IgE) and immunoglobulin D (IgD) indicated a favorable prognosis (Pr. less than .009). The SIPI was not as accurate as the SALPI in determining prognosis; however, when the indices were used simultaneously, concurring indices predicted the outcome of Stage III patients correctly 86% of the time.

Immunology of head and neck cancers

Despite the ever growing collection of data concerning the function of the immune system in patients with epidermoid carcinoma of the head and neck, the precise mechanism by which these tumors effect the body's surveillance against foreign antigen is as yet unidentified. If these specific immunological characteristics of the cancer cell can be identified, laboratory analysis of these "markers" could lead to detection and treatment of cancer in its earliest stages. Included in this chapter is a review of the embryological development of the immune system, a description of the components of the immune system and their responses to invasion by tumor antigen. Measurements of immuno responsiveness of the individual are important in determining the pretreatment state of immuno-competence and in predicting prognosis following treatment. Measurements of T-lymphocyte functions and their response to immuno-manipulations can also aid in predicting which patients will benefit from immunotherapy. Finally, categorization of the multiple forms of immunotherapy including active, specific and non-specific, and adoptive mechanisms are discussed. More recent methods of related immunotherapy trials will also be mentioned. As of this writing, the trials of immunochemotherapy have not produced any conclusive results due to the lack of multi-institutional trials and limited quantities of immunotherapeutic agents for these clinical trials.

Aggressive behavior of squamous cell carcinoma in a patient with preceding lymphocytic lymphoma

Actinically induced squamous cell carcinomas of the skin (SCC) are generally considered nonaggressive and usually curable tumors. However, in patients with lymphoma or leukemia, these tumors may behave in an extremely aggressive manner. We report a case in which an actinically induced SCC occurred in a patient with preceding lymphocytic lymphoma. The tumor progressed from a localized lesion to an invasive destructive lesion which resulted in death. The occurrence of SCC in patients with lymphoma or leukemia possibly should be more aggressively treated, early in its course.

Evaluation of peripheral blood T lymphocytes in renal adenocarcinoma before and after surgical removal of the tumor

Peripheral blood T lymphocytes were studied in 24 untreated patients with renal adenocarcinoma, 80 per cent of whom had local extension of the tumor. T lymphocytes were evaluated with the total and the active rosette assays, and were further submitted to stimulation by a range of phytohemagglutinin concentrations in vitro. Controls were healthy volunteers tested on the same days as the patients. Total E-rosette forming cells were slightly decreased but the difference compared to controls was not significant. Active rosettes were normal. When present lymphocytopenia affected total E-rosette forming cells. The mean of the log-converted stimulation indexes was reduced significantly in the patient group only when a suboptimal concentration of phytohemagglutinin was used. Total E-rosette forming cells returned to normal 3 weeks postoperatively but lymphocyte reactivity did not improve and active rosette forming cells remained within normal range. Thus, only minor abnormalities of T lymphocytes were disclosed in this study, suggesting functional alterations rather than depletion. Our study confirms that a cancer operation may act as immunotherapy.

Malignant lymphomas as tumours of the immune system

Malignant lymphomas have traditionally been classified on solely morphological grounds. With new immunological and cytochemical techniques, it has been possible to characterize normal cells of the T-lymphocyte, B-lymphocyte, and monocyte-macrophage system. Application of these methodologies to malignant lymphomas has established their nature as neoplasms of the immune system. Within the B-lymphocyte system it is possible to identify subpopulations responsible for Burkitt's tumour, follicular (nodular) lymphomas, lymphocytic lymphomas of intermediate differentiation and well differentiated lymphocytic lymphomas. The T-lymphocyte system includes lymphoblastic lymphomas, mycosis fungoides, and Sezary's syndrome. Large-cell lymphomas are diverse, but the majority are tumours of transformed lymphocytes, usually of the B-lymphocyte system. The precise nature of the neoplastic cells of Hodgkin's disease (i.e., Reed-Sternberg cells and their mononuclear counterparts) has not yet been established. Despite previous suggestions of a B-lymphocyte or T-lymphocyte origin, recent studies with in vitro cultivation have strongly suggested derivation from the monocyte-macrophage system.

Immunological status may predict clinical outcome in BCG treated melanoma

Twenty-seven patients with surgically resected stage II or III malignant melanoma were treated with bacillus Calmette-Guérin (BCG) and followed prospectively to determine whether relapse could be predicted. Peripheral blood mononuclear (lymphocyte plus monocyte) counts (PBM), T and B cell counts, phytohaemagglutinin (PHA) cytotoxicity, PHA transformation, antibody-dependent cell-mediated cytotoxicity (ADCC) and serum immunoglobulin concentrations were studied before and during therapy. Patients ultimately classified as having a poor clinical outcome (inoperable recurrence) were compared with those with a more favourable outcome. Prior to therapy, poor outcome patients had lower PBM and T cell counts but there was some overlap. After three months, these differences were more pronounced. Low PHA cytotoxicity was also associated with poor outcome; again the differences were more apparent at 3 months than prior to therapy. These results suggest that PBM, T cell counts and PHA cytotoxicity may predict poor outcome some months before inoperable recurrence in apparent clinically.

Immunobiology of head and neck cancer: basic concepts

Patients with squamous cancer of the head and neck have unique perturbations of the immune system. These patients have marked depression of cellular immunity even in the early stages of disease. The known facts about the immunobiology and the immunodeficiencies that commonly occur are discussed. Also reviewed are the relationships of the immunologic deficits to stage of disease, to prognosis, and to the suspected etiologic factors of smoking, alcoholism, and malnutrition. Highlights are given of current immunotherapeutic trials. To date, most of the successful efforts in both immunologic research and immunotherapy of head and neck cancer have dealt with general, rather than specific, immune reactions. Further development in the area of specific immune responses may permit more meaningful measurements of tumor-specific reactions, thus yielding useful tools for immunodiagnosis as well as providing more effective and precise methods of immunotherapy.

Aggressive biologic behavior of basal- and squamous-cell cancers in patients with chronic lymphocytic leukemia or chronic lymphocytic lymphoma

Three basal- and four squamous-cell carcinomas in seven patients with chronic lymphocytic leukemia or chronic lymphocytic lymphoma recurred repeatedly after conventional treatment, and grew to large sizes. The squamous-cell carcinomas metastasized in all four of the patients so afflicted. Absolute numbers of circulating T lymphocytes were normal in the seven patients, but they had cutaneous anergy to intradermal tests with common antigens and to dinitrochlorobenzene. The following recommendations for management of cutaneous carcinomas in patients with malignant lymphomatoses are made: 1) closer surveillance than for patients with cutaneous cancers but without malignant lymphomatoses, 2) early treatment of actinic keratoses to prevent possible transformation to malignancy, and 3) microscopically controlled excision of basal- or squamous-cell carcinomas larger than 1 cm in diameter.

Immunologic evaluation of patients with advanced head and neck cancer receiving weekly chemoimmunotherapy

Patients with advanced head and neck cancer have significant reduction in their circulating lymphocyte mass which is reflected in decreased numbers of T cells, Fc receptor cells, and in derangements of T lymphocyte functions, i.e., decreased responsiveness to several dilutions of phytohemagglutinin and lack of development of delayed hypersensitivity to 2,4-dinitrochlorobenzene (70% of patients were DNCB (-)). A population of phagocytic cells capable of decreasing lymphocyte responsiveness to mitogens were demonstrated. Removal of these cells resulted in an increment in lymphocyte responsiveness. Immunological impairment seemed to correlate with patients' ability to become sensitized to DNCB. Those patients who were DNCB (+) had less derangement in their immunological parameters. Weekly administration of Corynebacterium parvum in conjunction with chemotherapy did not have a discernible effect on patient's immune reactivity.

Immunological characterization of mononuclear cells in peripheral blood and regional lymph nodes of breast cancer patients

Mononuclear cells from peripheral blood and draining lymph nodes of 40 patients with invasive locoregional breast cancer were examined for immunological cell surface markers (E, EAhuman, EAox, EAC, SIg pos.). Concomitantly, blood lymphocytes from 36 healthy women and axillary and mesenteric lymph-nodes from patients without malignant diseases were tested as controls. In peripheral blood of tumor patients E rosette-forming cells were slightly diminished as compared to the control group, whereas EAox and EAC rosette-forming cells were increased. These differences may be age-dependent rather than tumor-related. In the draining lymph nodes of breast cancer patients as well as in the control lymph nodes, the percentages of EAC rosette-forming cells and SIg positive lymphocytes were significantly increased compared to peripheral blood, whereas E and EAhuman rosette values remained unchanged. Percentages of EAox rosettes on the other hand were strongly diminished in the draining lymph nodes, suggesting that the EAhuman and EAox rosetting techniques detect 2 types of Fc-receptor bearing cells. No significant differences were found between the cell surface marker analysis of tumor-free and metastatic lymph nodes of breast cancer patients and the control lymph nodes.

Identification and quantitation of B and T cells by cytofluorographic analysis

With cytofluorographic analysis (CFGA) of cells stained with the fluorescent dye acridine orange (AO), the major peripheral white cell populations--lymphocytes, monocytes, and polymorphonuclear cells--display different characteristics and appear as distinct populations which can be quantitated. In this study we present a method for determining percentages of human T and B cells lymphocyte subpopulations by CFGA and display of the data on a computer-generated 3-dimensional grid. Lymphocytes were depleted of either B, T, or both B and T cells by rosetting with erythrocytes and separated by centrifugation. The B cell and T cell depleted and non-rosetting cell subpopulations localized on constant, distinct areas of the display grid. The percentages of T and B cells in peripheral blood samples from 6 normals analyzed by CFGA did not differ from the results obtained by light microscope counting (LMC).

T and B lymphocytes in pleural effusions

To determine the diagnostic significance of the determination of T and B lymphocytes in pleural fluid, we studied these cells in peripheral blood and in pleural fluid by means of surface markers. Our study comprised 30 patients suffering from pulmonary tuberculosis, pulmonary malignancy, connective tissue disease, nonspecific pleurisy or congestive cardiac failure. In pulmonary tuberculosis, both the percentage and absolute numbers of T lymphocytes in pleural fluid were significantly higher than in peripheral blood. In patients with pulmonary tuberculosis, pulmonary malignancy or nonspecific pleuritis, the percentages and absolute numbers of B lymphocytes were significantly lower in pleural fluid than in peripheral blood. Considered together with other clinical and laboratory indices, these determinations may aid in the differential diagnosis of pleurisy of various etiology.

Spontaneous rosette formation and rosette inhibition assays in patients with squamous cell carcinoma of the head and neck

Peripheral blood lymphocytes from patients with squamous cell carcinoma (SCC) of the head and neck were studied by spontaneous lymphocyte rosette and rosette inhibition (RI) assays prior to treatment. The patients were clinically staged and the results of the assays compared with the clinical stage of the disease. The percentage of T-lymphocytes as determined by the spontaneous lymphocyte rosette test was significantly lower (p less than .01) for the patient group when compared with a normal population. Patients with stage I and II disease did not differ significantly from controls. Individuals with stage III or IV disease, however, had significantly lower T-lymphocyte counts. The tumors were histologically graded as well, moderately well, or poorly differentiated SCC. Patients with poorly differentiated neoplasms had significantly lower T-cell counts. The RI assay (using horse anti-human thymocyte globulin to inhibit rosette formation) was abnormal in many of the patients but did not appear to be a more sensitive in vitro measure of cell mediated immunity in these patients. Performing both tests detected more patients with cellular immunologic incompetence than either one alone.

Effect of thymosin in vitro on T cell levels during radiation therapy: correlations with radiation portal and initial T cell levels

The effect of thymosin in vitro on percent T cells was determined in 388 blood specimens from patients with head and neck, mediastinal, and pelvic malignancies during radiation therapy, in 94 untreated patients with these malignancies, and 277 normal adults. Changes in percent T cell levels after incubation of lymphocytes with thymosin did not correlate with tumor histology or cumulative radiation dose, but in all groups correlated with radiation portal and initial T cell levels. T cell levels increased by a similar increment in normals and in the untreated patients. During irradiation, the mean levels after incubation with thymosin did not change in patients with head and neck and pelvic malignancies, but in patients with mediastinal malignancies the levels increased significantly more than in normals. For a given T cell level, the increase in patients with mediastinal malignancies was greater than in patients with pelvic malignancies, and as a group was greater than in patients with head and neck malignancies. The results can be explained by an increase in circulating thymosin-responsive lymphocytes during mediastinal irradiation due to suppression of a function of the thymus important for maturation of these cells, and a decrease in these cells during pelvic irradiation due to a deleterious effect on precursors in pelvic bone marrow. The results thus provide a rationale for clinical trials to assess the efficacy of thymosin in averting declines of T cell levels in patients receiving mediastinal irradiation.

Thymosin reconstitution of T cell deficits in vitro in cancer patients

Thymosin, a soluble extract of fetal calf thymus, has increased cellular immunity in children with thymic deficiency. Prior to therapy, an increase in thymus-dependent lymphocyte (T cell) levels in vitro after incubation with thymosin correlated with a rise in peripheral blood T cell levels and improvement in other parameters of cellular immunity. These correlations constituted the basis for a study of the effects of thymosin on T cell levels in vitro in cancer patients. Groups studied were 350 untreated patients with local-regional solid malignancies, 157 patients cured of these tumors, 340 patients studied at 523 intervals during radiation therapy, 80 patients receiving chemotherapy for disseminated solid malignancies, and 427 normal volunteers. Although there were significant differences among the groups in mean leukocyte, lymphocyte and T cell levels, among those with low T cell levels in each group there was a significant inverse relation between T cell levels after incubation with thymosin in vitro and initial T cell levels, with the exception of patients receiving chemotherapy. In patients receiving chemotherapy, T cell levels increased independently of initial T cell levels. These in vitro observations are consistent with evidence that a major effect of thymosin is maturation of T cell precursors; however, the effect is that of reconstitution at low T cell levels, and not of elevation to levels significantly above normal. The results provide a rationale for clinical trials with thymosin to maintain immune competence during radiation therapy and chemotherapy, and for a two-phase approach to immunotherapy of cancer utilizing thymosin for reconstitution of cellular defects followed by administration of agents that potentiate cellular immunity.

Spontaneous human lymphocyte-mediated cytotoxicity againts tumour target cells. I. The effect of malignant disease

Spontaneous human lymphocyte-mediated cytotoxicity (SLMC) against tumour-cell targets was examined in a series of patients with localized or malignant disease, both treated and untreated, and patients with untreated chronic lymphocytic leukemia (CLL). The level of SLMC was assessed by means of two previously established assay systems; the xenogeneic assay involving the mouse mastocytoma line P815, and the allogeneic assay in which the human chronic myelogenous leukemia-derived line, K562, was used. The assay systems involve the use of Ficoll-Isopaque-separated, iron-plus-magnetism-purified lymphocytes in an overnight 51chromium release assay, and reflect the cytotoxic ability of human non-T, complement receptor-, Fc receptor-positive lymphocytes. In the present paper, lymphocytes from all normal donors tested showed significant activity in the SLMC assay, with some variation from day to day. This variation was markedly reduced when different normal donors were tested on the same day and under identical experimental conditions. In contrast, lymphocytes from many patients with malignant disease had decreased SLM activity, and this decrease was highly significant in patients with treated or untreated metastatic disease, or untreated CLL. This was also the case when the data were expressed relative to the number of cytotoxic cells in the normal control population, or in comparison to the relative SLMC activity of lymphocytes from patients with other conditions. Markedly decreased SLMC was observed in some patients in spite of normal T and B lymphocyte proportions, or the presence of the ability to mount a vigorous delayed hypersensitivity reaction to PPD. A comparison of the xenogeneic and allogeneic assays showed that the same information with respect to whether SLMC was normal or abnormal was obtained with both assays in the majority of cases. The significance of the data is discussed with respect to the possible role of SLMC in vivo and the relevance of SLMC to the assessment of specific cell-mediated cytotoxicity in malignant disease.

General immunocompetence and tumour-directed, cell-mediated hypersensitivity in vitro in patients with renal carcinoma

Thirteen patients with renal carcinoma were examined for tumour-directed, cell-mediated hypersensitivity (TCMH) by means of the leucocyte migration technique, and for general immunocompetence (GIC) by means of quantitation of T- and B-cells in peripheral blood and studies of lymphocyte transformation in vitro using a panel of antigens and mitogens. Eight out of 13 patients had evidence of TCMH, six out of 13 had abnormal GIC. Any correlation between the presence of TCMH and normal/abnormal GIC was not found. There was a trend towards a positive correlation between the absence of distant metastases and evidence of TCMH. If both TCMH and GIC were considered, significant correlation between the presence of distant metastases, lack of TCMH and/or abnormal GIC was demonstrated. It is concluded that the defect TCMH usually found in patients with renal carcinoma and disseminated disease cannot be explained exclusively by defects in GIC.

A technique for determining E rosette levels by cytofluorographic analysis

A method is described for determining the percentage of rosettes formed by sheep erythrocytes and human peripheral lymphocytes (ER) using cytofluorographic analysis (CFGA). The technique utilizes acridine orange dye for differentially staining nucleus and cytoplasm of the lymphocytes to distinguish them from erythrocytes, and glutaraldehyde for fixation of the rosettes. This technique was compared with light microscope counting (LMC) or ER. CFGA gave similar results with better reproducibility than LMC, entailed less time for counting, and markedly reduced operator fatigue.

Correlation of tumor burden with in vitro lymphocyte reactivity and antibodies to herpesvirus tumor-associated antigens in head and neck squamous carcinoma

In 94 patients with squamous carcinoma of the head and neck region, the clinical extent of tumor was correlated with in vitro lymphocyte reactivity (LR) to phytohemagglutinin (PHA) and serum complement-fixing antibodies to herpes simplex virus (HSV)-induced tumor-associated antigen (TAA). Forty-six patients were tumor-bearing and 48 were considered cured. Controls were 41 age-matched normals with histories of similar cigarette consumption. In 15 patients with Stage I carcinomas of the larynx, among whom the tumor diameter was 5 mm or less, mean LR or PHA did not differ from controls and 7 of 11 tested (63%) had antibodies to HSV-TAA. In 83 patients with more extensive tumors, LR to PHA was significantly lower than controls and 42 of 44 tested (95%) had antibodies to HSV-TAA. In both groups, LR to PHA was similar among tumor-bearing and cured patients. The study delineates a clinical tumor burden associated with impaired LR to PHA and a high incidence of antibodies to HSV-TAA in patients with squamous carcinomas of the head and neck region, and shows a correlation between the immune defects in clinically cured patients and tumor extent prior to treatment.