This review is an attempt to integrate the conflicting studies that constitute the literature on immunobiology of bladder cancer and to indicate areas that need further investigation. It is clear that immune reactivity directed at antigens expressed on bladder cancer cells and general host immunological competence decline with progressive tumor growth. This immunodepression correlates with patient prognosis, even within a given stage of disease. The mechanisms underlying this decline in host immune reactivity are poorly understood. A better understanding of these mechanisms may provide fundamental insight into the host-tumor relationship that possibly could be exploited for preventive, diagnostic and therapeutic purposes.
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