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November 1974

Evaluation of Immune Status in Tumor Patients-Reply

Author Affiliations

Portland, Ore

Arch Surg. 1974;109(5):718. doi:10.1001/archsurg.1974.01360050112025

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To the Editor.–An accurate immunologic staging procedure would be of great usefulness in determining prognosis and therapy for the cancer patient, and perhaps such staging will be possible at some future time. We would question the usefulness of the scheme proposed by Guinan et al for several reasons. The role of blocking or enhancement type antibodies in impeding immune responsiveness has not been defined. There is no solid evidence that establishes the role of IgG or IgM in tumor control. A general state of anergy or diminished dermal responsiveness to ubiquitous antigens is associated with diminished responsiveness of lymphocytes in culture to nonspecific mitogens, and this in our experience correlates with an unfavorable clinical course in the patient. It may be premature, however, to embark on a scheme for the clinical immune staging of cancer patients when the precise role of specific blocking factors, IgG and IgM, nonspecific

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