Immunological responsiveness in patients with bladder cancer.

Delayed cutaneous hypersensitivity tests, especially skin tests with dinitrochlorobenzene, are impaired increasingly as the amount of tumor increases. Recall antigens are less sensitive indicators of disease. Therapy, especially radiotherapy, also depresses cell-mediated immunity. Removal of tumor, however, allows these tests to return to normal. Dinitrochlorobenzene skin testing can contribute significantly to prognostic evaluation. An important facet of the tumor-host relationship is measured, and this reflects factors that are independent of tumor staging. Combination of tumor staging and dinitrochlorobenzene-delayed hypersensitivity testing can provide a strong indication of the clinical course, especially for the year following initial treatment of invasive or metastatic transitional cell carcinoma of the bladder.