Lymphocyte recovery in advanced ovarian cancer patients after high-dose chemotherapy and peripheral blood stem cell plus growth factor support: clinical implications.
OBJECTIVE
The purpose of this study was to investigate the clinical role of immunological recovery together with selected biological parameters on long-term survival in a series of ovarian cancer administered high-dose chemotherapy with peripheral blood stem cell and growth factor support.


METHODS
Thirty-eight patients with stages IIIB-IV epithelial ovarian cancer were studied. Lymphocyte immunophenotyping for the identification of CD3(+), CD4(+), CD8(+), and CD3(-)/CD16(+)CD56(+) natural killer T cells and CD19 B cells was performed.


RESULTS
Twenty-three patients (60%) had a CD3(+) cell count <850 cells/ microl. Multivariate logistic regression showed that tumor grading (chi(2) = 6.6, P = 0.010) and type of growth factor (chi(2) = 4.1, P = 0.042) retained an independent role in predicting T-cell recovery above the value of 850 cells/ microl. The 3-year time to progression (TTP) rate was 86% (95% confidence intervals, 70, 102) in cases with high CD3(+) cell count with respect to a 3-year TTP of 23% (95% confidence intervals, 8, 38) in cases with low CD3(+) cell count (P = 0.0026). The absolute number of CD3(+) cells was shown to be inversely associated with risk of progression (chi(2) = 4.8; P = 0.028), as assessed by Cox univariate analysis using CD3(+) cell count as continuous covariate. In multivariate analysis only residual tumor and status of CD3(+) cell counts retained an independent association with shorter TTP. Similar results were obtained for overall survival.


CONCLUSIONS
Long-term immune reconstitution and particularly the recovery of adequate counts of CD3(+), CD4(+), and CD8(+) T cells are independent markers of longer TTP and overall survival in ovarian cancer patients receiving high-dose chemotherapy with peripheral blood stem cell and growth factor support.
Ferrandina
Gabriella
G
Department of Gynecology, Catholic University of Rome, 00168 Rome, Italy.
Pierelli
Luca
L
Perillo
Alessandro
A
Rutella
Sergio
S
Ludovisi
Manuela
M
Leone
Giuseppe
G
Mancuso
Salvatore
S
Scambia
Giovanni
G
D017252:CD3 Complex / Q000096:biosynthesis; D015704:CD4 Antigens / Q000096:biosynthesis; D019002:CD56 Antigen / Q000096:biosynthesis; D005260:Female; D006133:Growth Substances / Q000627:therapeutic use*; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008214:Lymphocytes / Q000187:drug effects*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy*; D011379:Prognosis; D017452:Receptors, IgG / Q000096:biosynthesis; D012306:Risk
D017252:CD3 Complex; D015704:CD4 Antigens; D019002:CD56 Antigen; D006133:Growth Substances; D017452:Receptors, IgG