早期乳腺癌治疗后持续性淋巴细胞下降

Sustained lymphocyte decreases after treatment for early breast cancer

npj Breast Cancer

影响因子:7.6

分区:医学2区 Top / 肿瘤学2区

发表日期:2024 Oct 21

作者: Julia Dixon-Douglas, Balaji Virassamy, Kylie Clarke, Michael Hun, Stephen J Luen, Peter Savas, Courtney T van Geelen, Steven David, Prudence A Francis, Roberto Salgado, Stefan Michiels, Sherene Loi

DOI: 10.1038/s41523-024-00698-4

摘要

适应性免疫在早期乳腺癌长期预后中的作用日益受到关注。标准的（新辅助）辅助化疗可能对免疫细胞产生不良影响。本研究在单一机构对200名接受（新辅助）辅助化疗的早期乳腺癌患者的全血细胞计数（FBC）进行回顾性纵向分析，采集了治疗前至化疗后12个月的四个时间点的FBC结果。对匹配的化疗前后外周血单核细胞样本进行流式细胞术分析。结果显示，化疗后12个月的绝对淋巴细胞计数显著下降（p<0.01），在绝经前患者（n=73；p<0.01）、接受剂量密集化疗方案的患者（n=60；p<0.01）以及接受辅助放疗的患者（n=147；p<0.01）中尤为明显。在绝经前患者中，化疗后CD4+ T细胞亚群发生了显著变化。未来需要进一步研究，包括长期临床结局，以有效改善长期抗肿瘤免疫。

Abstract

The role of adaptive immunity in long-term outcomes in early breast cancer is increasingly recognised. Standard (neo)adjuvant chemotherapy can have adverse effects on immune cells. We conducted a retrospective longitudinal study of full blood counts (FBC) of 200 patients receiving (neo)adjuvant chemotherapy for early breast cancer at a single institution. FBC results at four time points from pre-treatment to 12 months post-chemotherapy were analysed. Flow cytometry was performed for patients with matched pre- and post-chemotherapy peripheral blood mononuclear cell samples. A significant decrease in absolute lymphocyte count at 12 months post-chemotherapy was observed (p < 0.01), most pronounced in pre-menopausal patients (n = 73; p < 0.01), patients receiving dose-dense chemotherapy regimens (n = 60; p < 0.01) and patients receiving adjuvant radiotherapy (n = 147, p < 0.01). In pre-menopausal patients, significant changes in CD4+ T cells subsets post-chemotherapy were observed. Further investigation, including long-term clinical outcomes, is needed to meaningfully improve long-term anti-tumour immunity.