Immunological variables as predictors of prognosis in patients with Kaposi's sarcoma and the acquired immunodeficiency syndrome

Multivariate analysis was used to identify which of a large number of pretreatment immunological parameters correlated with therapeutic response, subsequent development of oppor tunistic infection, and survival from the time of diagnosis in a group of 70 patients with Kaposi's sarcoma and acquired im munodeficiency syndrome treated with recombinant leukocyte A Interferon. In a logistic regression model, delayed type hypersen- sitivity response to one or more recall antigens and high prolif- erative response to Escherichia coli were significant predictors for response to recombinant leukocyte A interferon (for the model, P = 0.01). For prediction of the development of oppor tunistic infection, the model selected low proliferative responses to phytohemagglutinin and E. coli (P < 0.001). Favorable factors predicting survival in the Cox regression model were the absence of endogenous serum interferon activity and a high proliferative response to E. coli (P < 0.001 ). The estimated median survival for the group with endogenous serum interferon activity and low E. coli response was 12 months; the median has not yet been reached for the group with no serum interferon and a high E. coli response. We conclude that immunological parameters may be useful in predicting prognosis in patients with Kaposi's sarcoma