INCONSISTENT EXPRESSION OF HLA-B ANTIGENS ON PERIPHERAL-BLOOD LYMPHOCYTES OF STAGE-I MELANOMA PATIENTS - AN INDICATOR OF POOR-PROGNOSIS

The survival of stage I melanoma patients was evaluated and compared w ith the detectable expression of HLA antigens. Of 904 patients who wer e surgically treated, 219 were HLA typed on peripheral blood lymphocyt es. Four consecutive HLA typings were considered necessary. Median fol low-up was 8 years. Two main groups of patients were considered: (a) p atients with consistent detectable expression of antigens; and (b) pat ients with inconsistent detectable expression of antigens. Patients wi th consistent HLA antigens detection had an 8-year survival tate of 87 .7% compared with 49.2% of patients with an inconsistent rate (P 10(-7 )). Multivariate analysis of survival of the 182 HLA-typed patients wh o survived at least 24 months from surgery showed that two of the crit eria had an independent impact on survival: tumour thickness (P 0.02) and HLA typing (P 2 x 10(-5)). Inconsistent detection of HLA antigens on peripheral blood lymphocytes during the first 24 months after surge ry is an indicator of poor prognosis in stage I melanoma patients.