Relation of prenephrectomy CD profiles and serum cytokines to the disease outcome and response to IFN-alpha/IL-2 therapy in renal cell carcinoma patients

Immune parameters, including cytokine levels and CD profiles were determine d in 78 renal cell carcinoma patients (RCC) prior to nephrectomy. The value s were correlated with the outcome of disease and response to cytokine-base d treatment during a 3-year follow-up. Significantly lower frequency of pro gressions and higher proportion of survivors were recorded in 24 treated pa tients compared to 43 untreated ones (22.9% vs. 53.5% and 82.9% vs. 55.8%) illustrating the beneficial effect of immunotherapy on the course of RCC at localized stage. RCC-related immune changes are demonstrated by reduced pr oportion of CD19(+), CD28(+), HLA-DR+, CD19(+)/80(+) and CD8(+)/28(+) subse ts, by increased serum levels of IL-6, sIL-2R, CRP and by impaired producti on of IL-2 and TNF-alpha released by in vitro stimulated PBMC. Only increas ed CRP, IL-6 serum values, decreased CD8(+) and increased CD122(+) were sig nificantly related to patients' prognosis. Comparisons of preoperative CD p rofiles and cytokine Values with the response to IL-2/ IFN-alpha based ther apy disclosed significant correlation in only CD80(+) and CD19(+)/80(+) sub sets. Treated patients who relapsed during the 3-year follow-up exhibited a t the diagnosis significantly reduced proportion of CD80(+) and CD19(+)/80( +) cells (CD80(+) means - 0.79 vs. 1.69 and CD19(+)/80(+) means 0.32 vs. 0. 61) comparing to those surviving disease-free. In addition initial proporti on of CD3(+), CD8(+) and CD19(+) cells was reduced in treated patients who manifested progression but statistical difference from those remaining dise ase-free was not proved.