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.
D000328:Adult; D000368:Aged; D000920:Antibody-Dependent Cell Cytotoxicity; D001402:B-Lymphocytes; D001500:BCG Vaccine / Q000627:therapeutic use*; D003602:Cytotoxicity, Immunologic / Q000187:drug effects; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D007958:Leukocyte Count; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D008875:Middle Aged; D009000:Monocytes; D010835:Phytohemagglutinins / Q000494:pharmacology; D011379:Prognosis; D012882:Skin Tests; D013601:T-Lymphocytes
D001500:BCG Vaccine; D007136:Immunoglobulins; D010835:Phytohemagglutinins