Cancer caused by an inherited selective defect in immunological surveillance

Evaluation of possible causes of delayed hypersensitivity impairment in cancer patients

The separate roles of malnutrition, advanced age, and stage of tumor growth as causes of impairment of delayed hypersensitivity response (DHR) was studied in 111 patients with solid tumors and in 56 nonneoplastic control patients matched for age, anatomical site of disease, degree of illness, and nutritional status. Pretreatment DHR to recall antigens (tuberculin, Candida, streptokinase-streptodornase, trichophyton) and to dinitrochlorobenzene in cancer patients with 9% anergic, 43% hypoergic, and 48% normoergic; the distribution of DHR in controls was not significantly different. In cancer patients, the serum albumin level showed an inverse correlation with the stage of tumor (p less than 0.01) and a positive correlation with the DHR (p less than 0.001); the serum albumin level was also in the controls positively correlated with the DHR (p less than 0.01), indicating that malnutrition in neoplastic or benign disease may cause depression of DHR. In well-nourished controls, age was inversely correlated with DHR (p less than 0.05), showing that aging itself may be another relevant cause of depression of DHR. The results of this study indicate that DHR in patients with solid tumors is similar to the DHR of nonneoplastic patients if matched for age, sex, and nutritional status. DHR impairment in cancer patients appears to be caused mainly by aging and by malnutrition due to the advanced progression of cancer.

Phytohemagglutinin-induced lymphocyte transformation in newly presenting patients with primary carcinoma of the lung

The transformation of peripheral blood lymphocytes in response to PHA was studied in 37 newly presenting patients who were subsequently proven to have carcinoma of the lung. When compared with healthy age- and sex-matched normal controls, no differences were noted in the thymidine uptake of the unstimulated lymphocytes in culture or in the response to any of the three dose levels of PHA used. Neither the extent of the spread of the carcinoma nor the type of its histology showed any correlation with the PHA response, but the PHA response was significantly depressed within 14 days of death in 7 patients. No evidence for serum inhibitory factors was found.