Abstract
Sixteen consecutively admitted patients with malignant melanoma were skin tested with autologous tumor extract (ATE), a variety of cutaneous antigens, and when available, autologous normal skin extracts (ASE). A protein concentration of 1 mg/ml was used as the critical antigenic challenge for both ATE and ASE testing. Anergy was not encountered in any of this group. Positive delayed sensitivity reactions to ATE were elicited in 11 patients, 9 of whom were also tested with ASE. Six of the nine (67%) reacted to the ASE as well. The implications of concomitant ATE and ASE reactivity are discussed. No correlation was noted between ASE reactivity and the presence of vitiligo in these patients. No correlation was noted between ATE skin-test reactivity and sex, age, length of history prior to hospitalization, primary disease site, presence of regional node involvement, distant metastases, vitiligo, or duration of remission, even in the 3 patients reacting to ATE and not to ASE. Naturally occurring cutaneous reactivity to extracts of autologous melanoma cells does not currently appear to represent an effective immunological barrier to tumor progression, though future studies may suggest significant clinical application of this phenomenon.
