Patient survival after chemotherapy and its relationship to in vitro lymphocyte blastogenesis

To study the relationship between chemotherapy immunocompetence and prognosis, in vitro lymphocyte blastogenic responses were studied serially, in 40 patients, receiving intensive chemotherapy for metastatic solid tumors. Suppression of lymphocyte blastogenic responses to phytohemagglutinin and streptolysin “O” was similar in all patients at the end of chemotherapy and was highly significant (PHA: P < 0.01, SLO: P < 0.02). Recovery of such responses occurred with significant overshoot above the pretreatment levels (P < 0.01) for PHA and SLO in those patients whose tumors regressed and survival was long, while such recovery was lacking in those patients whose tumors progressed and whose survival was short (PHA: P < 0.01, SLO: P < 0.05). This shows that the rebound with overshoot of immunologic reactivity after chemotherapy correlates with tumor regression and prognosis, and continued suppression may be an indicator of poor prognosis.