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Peripheral blood lymphocyte depletion after hepatic arterial 90Yttrium microsphere therapy for hepatocellular carcinoma.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2012 Mar 01; Vol. 82 (3), pp. 1179-84. Date of Electronic Publication: 2011 May 23. - Publication Year :
- 2012
-
Abstract
- Purpose: The short- and long-term effects of (90)Yttrium microspheres therapy for hepatocellular carcinoma (HCC) on peripheral blood lymphocytes are unknown and were therefore examined.<br />Methods and Materials: Ninety-two HCC patients were enrolled in a (90)Yttrium therapy study and routine blood counts were examined as part of standard clinical monitoring.<br />Results: We found an early, profound, and prolonged lymphopenia. In a subsequent cohort of 25 additional HCC patients, prospective flow cytometric immune-monitoring analysis was performed to identify specific changes on distinct lymphocyte subsets (i.e., CD3, CD4, CD8 T, and CD19 B lymphocytes) and NK cells absolute numbers, in addition to the granulocytes and platelets subsets. We found that the pretreatment lymphocyte subset absolute numbers (with the exception of NK cells) had a tendency to be lower compared with healthy control values, but no significant differences were detected between groups. Posttherapy follow-up revealed that overall, all lymphocyte subsets, except for NK cells, were significantly (>50% from pretherapy values), promptly (as early as 24 h) and persistently (up to 30 months) depleted post-(90)Yttrium microspheres therapy. In contrast, granulocytes increased rapidly (24 h) to compensate for lymphocyte depletion, and remained increased at 1-year after therapy. We further stratified patients into two groups, according to survival at 1 year. We found that lack of recovery of CD19, CD3, CD8, and especially CD4 T cells was linked to poor patient survival. No fungal or bacterial infections were noted during the 30-month follow-up period.<br />Conclusions: The results show that lymphocytes (and not granulocytes, platelets, or NK cells) are sensitive to hepatic arterial (90)Yttrium without associated clinical toxicity, and lack of lymphocyte recovery (possibly leading to dysregulation of adaptive cellular immunity) posttherapy indicates poor survival.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Subjects :
- Blood Platelets radiation effects
Carcinoma, Hepatocellular blood
Carcinoma, Hepatocellular immunology
Carcinoma, Hepatocellular mortality
Female
Granulocytes cytology
Granulocytes radiation effects
Humans
Killer Cells, Natural radiation effects
Leukocytes radiation effects
Liver Neoplasms blood
Liver Neoplasms immunology
Liver Neoplasms mortality
Lymphocyte Subsets radiation effects
Lymphopenia blood
Male
Middle Aged
Carcinoma, Hepatocellular radiotherapy
Liver Neoplasms radiotherapy
Lymphocyte Depletion
Microspheres
Yttrium Radioisotopes therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1879-355X
- Volume :
- 82
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 21601995
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2010.10.042