The prognostic value of peripheral blood lymphocyte subsets in patients with bladder carcinoma treated using neoadjuvant M-VEC chemotherapy

Objectives To assess the prognostic value of peripheral blood lymphocyte su bsets in patients with bladder cancer who were treated with neoadjuvant che motherapy. Patients, subjects and methods Thirty patients with a histological diagnosi s of invasive bladder transitional cell carcinoma and 30 age-matched contro ls with no evidence of cancer and immunological disorders were evaluated. P eripheral blood samples were assessed in both groups using monoclonal antib odies. Patients with bladder cancer who achieved complete or partial respon ses and those who had progression of the disease after systemic chemotherap y with methotrexate, vinblastine, epirubicin and cisplatin were compared ac cording to the pretreatment values of the peripheral blood lymphocyte subse ts. Results There were no significant differences in B lymphocyte levels betwee n the groups. In patients with bladder cancer, the percentages of T lymphoc ytes (P < 0.01), natural killer (NK) cells (P < 0.05) and the CD4+/CD8+ rat io (P < 0.05) were significantly lower than in the control group. In patien ts who responded to the chemotherapy regimen, the pretreatment values of T lymphocytes (P < 0.001), the CD4+/CD8+ ratio (P < 0.01) and NK cell levels (P < 0.01) were significantly higher than in the patients who did not. Conclusion In patients with invasive bladder carcinoma, cell-mediated immun ity may have a role in the resistance to this malignancy and in these patie nts the pretreatment levels of T lymphocyte subsets may be an indicator of the potential response to chemotherapy.