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We present the comparative analysis of human leukocyte antigen (HLA) class I expression in recurrent bladder tumors in patients treated with mitomycin or BCG. HLA class I expression was analyzed by RT\u2010Q\u2010PCR and immunohistochemical techniques. Loss of heterozygosity (LOH) was determined by microsatellite amplification of markers in chromosome 6 and 15. More profound alterations in HLA class I expression were found in post\u2010BCG recurrent tumors than in pre\u2010BCG lesions, whereas mitomycin treatment did not change the HLA class I expression pattern. Post\u2010BCG recurrent tumors also showed a higher incidence of structural defects underlying altered HLA class I expression. We hypothesize that the immunotherapy\u2010activated immune system recognizes and eliminates tumor cells with reversible (\u201csoft\u201d) HLA class I changes but not transformed cells with additional, irreversible (\u201chard\u201d) alterations. To our knowledge, this is the first clinical evidence of immunotherapy\u2010induced immunoselection of HLA class I loss tumor variants in bladder cancer, although the study involved a small number of patients.<\/jats:p>","DOI":"10.1002\/ijc.25733","type":"journal-article","created":{"date-parts":[[2010,10,18]],"date-time":"2010-10-18T14:18:41Z","timestamp":1287411521000},"page":"839-846","source":"Crossref","is-referenced-by-count":54,"title":["Bacillus Calmette\u2010Guerin immunotherapy of bladder cancer induces selection of human leukocyte antigen class I\u2010deficient tumor 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