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Critical Evaluation of Lymphocyte Functions in Urological Cancer Patients¹

Departments of Surgery/Urology, Microbiology, and Immunology, University of California, Los Angeles 90024 and Department of Surgery/Urology, Harbor General Hospital, Torrance, California 90509

One hundred three patients with varying stages of urological cancer (bladder, prostate, kidney) were investigated with regard to the following lymphocyte functions. T-cells were assessed numerically (E rosettes), their blastogenic response to phytohemagglutinin (PHA) was determined, and their cytotoxic potential against heterologous target cells in short-term presence of PHA (i.e., PHA-dependent cellular cytotoxicity) was evaluated. Similarly, B cells were numerically assessed (EA rosettes), and their function was evaluated by antibody-dependent cellular cytotoxicity against antibody-coated heterologous target cells. The data on cancer patients, divided on the basis of extent of disease and prior radiation therapy, were compared to those of normal young and age-matched controls.

Our investigations emphasize the importance of the following factors: (a) comparison of data with age-matched controls, since several lymphocyte functions appear to change with age; (b) use of multiple controls to compensate for the inherent variability found in certain tests; (c) minimized contamination by nonlymphoid cells in the purified cell preparation; and (d) the influence of certain treatment regimens (radiation, chemotherapy, etc.) on the results.

Radiotherapy significantly depressed T-cell number with a depression of PHA blastogenic responses as well as PHA-dependent cellular cytotoxicity.

When all of these conditions were taken into account, the urological cancer patients as a group were found to have a lower proportional value of E rosettes (T-cells) and a reduced PHA blastogenic responsiveness. Certain cancer patients displayed an elevated PHA-dependent cellular cytotoxicity as compared to age-matched controls, which may indicate the presence of activated cells in the presence of tumors. With this identification of a group of cancer patients with markedly depressed E rosette values and PHA responsiveness, it will now be possible to follow them clinically in comparison with a group of cancer patients with normal T-cell functions.

¹ These investigations were supported by National Bladder Cancer Project Grant CA 16880.

² To whom requests for reprints should be addressed, at Department of Urology, Sherbrooke University, Sherbrooke, Quebec, Canada.

Received 6/18/75. Accepted 10/ 2/75.