title: Interaction of tamoxifen with concurrent cytotoxic adjuvant treatment affects lymphocytes and lymphocyte subsets counts in breast cancer patients.
abstract: The effects and interaction of endocrine and cytotoxic adjuvant treatment on measures of cellular immunity were assessed in 41 stage I-II breast cancer patients from International Breast Cancer Study Group trials. Counts of lymphocytes and lymphocyte subsets [(T, T4, T8, B, natural killer (NK) and activated T (AT) cells] were assessed by flow cytometry immediately before adjuvant therapy at baseline and on day 1 of the 3rd cycle. Twenty-two patients received cyclophosphamide, methotrexate and 5-fluorouracil (CMF), 7 CMF and tamoxifen (TAM), and 12 TAM alone. On day 1 of the 3rd cycle the counts of total lymphocytes (P = 0.003) and all lymphocyte subsets (P<0.05) except AT cells were significantly lower than baseline in the CMF treatment group. There was no significant change in the CMF+TAM or in the TAM treatment group. The combination of CMF and TAM resulted in less pronounced decrease in lymphocyte and subset counts from baseline to day 1 of the 3rd cycle. It seems possible that there is an interaction between TAM with CMF that affects lymphocyte and lymphocyte subset counts during cytotoxic treatment.
authors.affiliation: Medical Division Lory-Haus, University Hospital Insel, Berne, Switzerland. marzio.sabbioni@insel.ch
authors.forename: M E
authors.initials: ME
authors.lastname: Sabbioni
authors.forename: M
authors.initials: M
authors.lastname: Castiglione
authors.forename: C
authors.initials: C
authors.lastname: Hürny
authors.forename: H P
authors.initials: HP
authors.lastname: Siegrist
authors.forename: M
authors.initials: M
authors.lastname: Bacchi
authors.forename: J
authors.initials: J
authors.lastname: Bernhard
authors.forename: B
authors.initials: B
authors.lastname: Thürlimann
authors.forename: H
authors.initials: H
authors.lastname: Bonnefoi
authors.forename: L
authors.initials: L
authors.lastname: Perey
authors.forename: A
authors.initials: A
authors.lastname: Goldhirsch
authors.forename: H J
authors.initials: HJ
authors.lastname: Senn
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D016175:B-Lymphocyte Subsets / Q000187:drug effects*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000276:immunology*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004347:Drug Interactions; D005260:Female; D005434:Flow Cytometry; D005472:Fluorouracil / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000187:drug effects*; D013629:Tamoxifen / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen; D002945:Cisplatin; D005472:Fluorouracil; D008727:Methotrexate