Immunological alterations induced by adjuvant treatment of postoperative colon carcinoma Duke's B or C with levamisole in combination with 5-FU.
BACKGROUND
Postoperative 5-FU combined with levamisole increases 5 year survival in colon cancer patients (Duke C) by 30% (1). In order to investigate the potential immunological mechanism, we determined lymphocyte subtypes and markers of immune activation in 22 patients before and during one year of postoperative adjuvant treatment.


METHODS
Before and regularly during treatment, according to the scheme described by Moertel (1), major lymphocyte subsets were quantified by flow cytometry. Serum neopterin, soluble IL2-receptors, beta 2-microglobulin, TNF-alpha and interferon-gamma were determined by Elisa.


RESULTS
The CD4/CD8 ratio increased significantly after levamisole was added to the treatment, as did the levels of soluble IL2-receptors. The percentages of T-cells expressing the interleukin 2 receptor followed a similar trend. The levels of neopterin tended to decrease during the combined treatment course. This was paralleled by a progressive fall in the proportion of T-cells expressing HLA-DR.


CONCLUSIONS
The treatment induced significant and consistent alterations in major immunological mediators and lymphocyte subtypes. It remains to be established whether these changes are related to the therapeutic effect.
De Brabander
M
M
Clinical Research Unit St. Bartholomeus, Jan Palftjn Hospital, Merksem, Belgium.
Vandebroek
J
J
Wassenaar
H
H
De Crée
J
J
Baisier
A
A
Demoen
B
B
De Ridder
R
R
Jagers
E
E
Roels
V
V
Vogels
O
O
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016516:CD4-CD8 Ratio / Q000187:drug effects; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D017493:Leukocyte Common Antigens / Q000032:analysis; D007978:Levamisole / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015375:Receptors, Interleukin-2 / Q000032:analysis; D013601:T-Lymphocytes / Q000187:drug effects
D000276:Adjuvants, Immunologic; D015375:Receptors, Interleukin-2; D007978:Levamisole; D017493:Leukocyte Common Antigens; D005472:Fluorouracil