Effects of adjuvant chemotherapy on specific and non-specific immune mechanisms.
Adjuvant chemotherapy is a well accepted concept in the treatment of breast cancer and has resulted in most clinical studies in a significant prolongation of the disease-free interval in certain subgroups of patients. However, very little is known about the late effects of adjuvant chemotherapy and its influence upon the function of a series of physiologic mechanisms. In the present paper, a review of our studies on the influence of adjuvant chemotherapy consisting of cyclophosphamide, methotrexate and fluoruracil (CMF) upon the function of B, T and natural killer (NK) cells is given. It is shown that CMF adversely influenced primary antibody production following vaccination for a prolonged period of time after the termination of CMF treatment. In investigating T cell function, it was found that the administration of CMF led also to a similarly prolonged impairment of phytohemagglutinin (PHA-)stimulated soluble interleukin 2 receptor (sIL-2R) production and to a decrease in the proliferation of peripheral blood mononuclear cells following mitogenic stimulation with PHA. Finally, NK cell activity was found to be decreased for such a prolonged period of time after the termination of CMF treatment, too. We thus conclude that the administration of CMF in the adjuvant setting leads to a pronounced and prolonged impairment of certain immune mechanisms.
Zielinski
C C
CC
IInd Department of Medicine, University Hospital, Austria.
Müller
C
C
Kubista
E
E
Staffen
A
A
Eibl
M M
MM
D000917:Antibody Formation / Q000187:drug effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000187:drug effects; D001943:Breast Neoplasms / Q000188:drug therapy / Q000276:immunology* / Q000601:surgery; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects; D007694:Killer Cells, Natural / Q000187:drug effects; D008213:Lymphocyte Activation / Q000187:drug effects; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D015375:Receptors, Interleukin-2 / Q000187:drug effects; D013601:T-Lymphocytes / Q000187:drug effects
D015375:Receptors, Interleukin-2; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate