Lymphocyte anergy in patients with carcinoma.

All of 10 patients with colonic carcinoma and 5 with malignant melanoma of skin showed no sign of immunoreactivity against the cultured tumour cells by the lymphocyte populations residing within the tumours. More than half of these patients did show cytotoxic reactivity by their blood lymphocytes. Possible cytotoxic reactivity by the regional lymph node lymphocytes was also investigated in 57 tumour cases (44 colonic, 13 melanoma, and including 12 of the 15 examined for intrinsic lymphocyte activity). One third of the cases showed positive blood lymphocyte immunoreactivity, but in only 4 tumours (3 colonic) did the node lymphocytes show any cytotoxicity against the tumour cells. This state of anergy of intrinsic and regional lymphocytes is presumably acquired during the development of the cancer and would permit local tumour spread and metastasis to lymph nodes. Its cause has not been identified but appears to be lymphocyte inhibition rather than selective change in lymphocyte population. In particular, no special pattern can be seen in the relative proportions of T and B cells in patients' blood, lymph node or intrinsic carcinoma lymphocytes.