The impact of leukapheresis on immune-cell number and function in patients with advanced cancer
The impact of leukapheresis on immune-cell number and function in patients with advanced cancer
复制标题
DOI：
10.1007/s00262-015-1738-9
复制
发表时间：
2015-11-01
影响因子：
5.8
通讯作者：
Schlom, Jeffrey
中科院分区：
文献类型：
--
作者：
Gulley, James L.;Marte, Jennifer;Schlom, Jeffrey
白细胞分离术通常在癌症患者身上进行，以采集干细胞，制造治疗性疫苗，或跟踪治疗的免疫反应。我们最近描述了白细胞分离对正常供者的最小影响。在此，我们提供了接受白细胞分离术的晚期癌症患者的额外免疫学数据。使用临床试验中接受白细胞分离术(n=)和只抽取外周血(n=90)的癌症患者的数据作为免疫分析的对照，我们评估了白细胞分离术对淋巴细胞数量和功能的影响。在白细胞分离组，中位年龄为63.5岁(38-82岁)；87.5%是男性。比较两组内分离前和分离后的值，每个患者作为自己的对照，在酶联免疫吸附斑点(ELISPOT)、抗载体体液反应、绝对淋巴细胞计数(ALC)和T细胞计数方面没有显著差异。12名患者完成了三次白细胞移植，随后进行了Elispot分析；7名患者对流感的反应增加(1.1倍至2.3倍)，分布均匀，几乎没有变化。19名患者在完成三次白细胞分离后ALC值匹配，与基线没有明显变化。这些数据提供了证据，表明白细胞分离在数量或功能上对癌症患者的免疫系统没有可检测到的影响。这些结果提供了越来越多的证据，反驳了患者的免疫能力受到手术有意义影响的假设。限制包括限制2-L白细胞分离程序和小样本量。
Leukapheresis is often performed in cancer patients to harvest stem cells, manufacture therapeutic vaccines, or follow immunologic response to therapy. We have recently described the minimal impact of leukapheresis on normal donors. Here we provide additional immunologic data from patients with advanced cancer who underwent leukapheresis.Using data from cancer patients on clinical trials who had leukapheresis (n = 64) or peripheral blood draws only (n = 90) as controls for immune analysis, we evaluated the impact of leukapheresis on number and function of lymphocytes.In the leukapheresis group, median age was 63.5 (range 38-82); 87.5 % were male. Comparing pre- and post-leukapheresis values within the groups, with each patient as its own control, there was no significant difference in enzyme-linked immunosorbent spot (ELISPOT), antivector humoral response, absolute lymphocyte count (ALC), or T cell number. Twelve patients completed three leukaphereses with subsequent ELISPOT analysis; seven had increased responses to flu (1.1- to 2.3-fold) with an even distribution around no change. Nineteen patients had matched ALC values after completing three leukaphereses with no significant change from baseline.These data provide evidence that leukapheresis has no detectable effects on a cancer patient's immune system in terms of number or function. These results contribute to a growing body of evidence refuting the hypothesis that a patient's immune competence is meaningfully affected by the procedure. Limitations include a restriction to 2-L leukapheresis procedure and small sample size.