The immune system can deal effectively with the majority of viruses and bacteria, less effectively with parasites, and very poorly with cancer. Why is this so? Why are McFarlane Burnet's and Lewis Thomas' predictions that the immune system is in volved in ridding the body of cancer cells, encapsulated in the catchy phrase "immunologic surveillance," so difficult to experi mentally establish? Cancer differs from infectious agents in being derived from the host. Hence, it has been postulated that cancer cells lack anti gens that the immune system can recognize. They are not "im munogenic. " However, this argument is seriously weakened by the existence of numerous human autoimmune diseases, in which the immune system effectively recognizes and attacks a va riety of self tissues. Thus, the potential clearly exists for recogni tion of the surfaces of tumor cells. Professor Naor and his colleagues have written a book that explores another possible reason: cancer cells are recognized by the immune system-but is it possible that the consequence of recognition is inhibition of the immune system-by suppressor T cells or macrophages? The evolution of the malignant state may only occur in individuals who develop this suppression. This book reviews the evidence that suppressor cells, poorly characterized and difficult to study, may be of fundamental im portance in cancer. In fact, our incapacity to understand the na ture of suppressor cells and their mode of action is one of the ma jor problems in immunology research today."

This original and incisive new book by Naor and his colleagues, Immunosuppression and Human Malignancy, offers a state-of-the-art critical analysis of the huge body of recent research on the immunosuppressive states associated with malignancy. Maximum attention is paid to the role of suppressor macrophages and lymphocytes in malignancy-related immunodepression. The central question posed is whether immunosuppression induces carcinogenesis and/or tumor progression, or whether it is instead the result of these processes and/or the therapy protocols. Sources of experimental artifacts are also evaluated. Encyclopedically presented, each chapter of Immunosuppression and Human Malignancy can be read independently, and each chapter features a detailed table summarizing that chapter's major findings, providing the reader with concise material to aid in evaluation. Investigators initiating work in the field will find it an especially valuable reference guide, as well as a useful tool in comparing findings published by all the major laboratories in the field. Students of medicine will find novel perspectives complementing the basic information gleaned from lectures and textbooks.Since certain treatment protocols for malignant diseases have already taken into account cause-effect relationships between tumors and immunodepression, physicians may also wish to use the book in evaluating their varied treatments, or perhaps the potential hazards associated with specific therapies. Immunosuppression and Human Malignancy appears at a time of intensive debate on the existence of suppressor T cells. Whereas immunosuppression per se has been well established, the community of immunologists is divided in its opinion about the role that suppressor T cells play in mediating this phenomenon; at the extreme end their existence has been completely denied. Although the book cannot definitely resolve this problem, it provides all the arguments for both supporters and opponents of suppressor T cells, and it may serve to stimulate formulation of alternative immunosuppression interpretations.