Lymphocyte response and radiation therapy for patients with gynecologic cancer

To relate radiotherapy, lymphocyte responses, and clinical course for patients with gynecologic lesions, responses to phytohemagglutinin (PHA), concanavalin A (Con A), and pokeweed mitogen (PWM) were measured in whole-blood cultures before and after radiotherapy. For 82 patients tested before radiotherapy, lymphocyte counts and responses to PHA, Con A, and PWM were 79, 62, 55, and 67% of control values, respectively. For 29 patients who died within 18 months, the pretreatment lymphocyte count was 80% and mitogenic responses were about one-half of values for 37 patients who lived beyond 18 months. During radiotherapy lymphocyte counts declined to about 30% and mitogenic responses declined to about 10% of control values. For patients who lived beyond 18 months, PWM and Con A responses recovered to pretreatment values within 13–18 months and lymphocyte counts recovered within 19–24 months. PHA response, however, failed to recover above 70% of the pretreatment response. In contrast, patients who died within 18 months had no increase in lymphocyte counts or mitogenic responses after treatment. In general, depressed pretreatment responses to PHA and Con A correlated with a poor clinical course and responses near control levels indicated a good clinical course.