Peripheral blood T-lymphocyte and monocyte function and survival in patients with head and neck carcinoma

Objectives/Hypothesis: To determine if the T-lymphocyte and monocyte functi ons of peripheral blood mononuclear cells (PBMCs) from patients with head a nd neck squamous cell carcinomas (HNSCC) are predictive factors for outcome . Study Design A prospective study describing the outcome, as to total surv ival and death by disease after at least 40 months observation, of 81 previ ously untreated male HNSCC patients in relation to PBMC T-lymphocyte and mo nocyte function. Methods: T-lymphocyte mitogenesis and the cytokine level i n culture supernatants of PBMC as well as monocytes were analyzed. These pa rameters were related to survival by Cox regression and Kaplan-Meier surviv al analysis. Results: When patients with high versus low T-lymphocyte mitog en-stimulated proliferations were compared, a decreased proliferation was s een to be related to worse outcome. The predictive value of T-lymphocyte pr oliferation was shown to be an independent prognostic factor when adjusted for stage and stratified for anatomic location in survival analysis. The pr edictive value was also retained when the serum values of the major serum p roteins and hormones and scores based on the smoking and alcohol history we re added to the survival analysis with lymphocyte proliferation. Supernatan t levels of gamma-interferon, interleukin (IL)-2, or IL-4 in PBMC cultures were not related to outcome. Monocyte function measured by endotoxin-stimul ated IL-1 beta, IL-6, IL-12, and tumor necrosis factor-alpha secretion did not relate to outcome of the patients. Conclusion: The PBMC T-lymphocyte-st imulated proliferation is an independent prognostic factor for male HNSCC p atients.