title: Immune response, depression and fatigue in relation to support intervention in mammary cancer patients.
abstract: OBJECTIVE
  To study the effect of support intervention on immune function in breast cancer patients.
  
  
  METHODS
  Breast cancer patients from an ongoing prospective randomised quality-of -life study were chosen for assaying immune functions in relation to a support-group intervention program running on a residential basis. Twenty-one women received adjuvant-combined radio-chemotherapy (CT-RT) and 20 women radiotherapy (RT). Eleven CT-RT and ten RT patients were randomised to support-group intervention, the rest served as controls. Immune tests for NK cells and NK-cell cytotoxicity, as well as lymphocyte subpopulations and response to antigen were performed before intervention, 2, 6, and 12 months later, in parallel to controls and healthy volunteers (n = 11). Depression, anxiety and fatigue were evaluated by the Hospital Anxiety and Depression (HAD) and the Norwegian Fatigue questionnaire. The density of NK cell receptors and in vitro quantitation of functional NK cytotoxicity against K562 cell line were evaluated. Four-colour flow cytometry was used to detect signal transduction molecules and cytokine expression. T-cell proliferate response to purified protein derivate (PPD) antigen was evaluated.
  
  
  RESULTS
  No significant immune effect of support intervention could be found. The immune variables were severely disarranged compared to healthy volunteers but showed a statistically significant improvement over time. The majority of patients suffered from fatigue but had low scores for depression and anxiety.
  
  
  CONCLUSIONS
  No effect on immune parameters could be detected from support intervention. The long-lasting immune suppression might override a putative effect of the intervention. Low depression scores may contribute to the absence of a detectable effect.
authors.affiliation: Immune and Gene Therapy Laboratory, Cancer Centre Karolinska, Karolinska University Hospital Solna, Stockholm, Sweden. christina.lindemalm@gmail.com
authors.forename: Christina
authors.initials: C
authors.lastname: Lindemalm
authors.forename: Fariba
authors.initials: F
authors.lastname: Mozaffari
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Choudhury
authors.forename: Helena
authors.initials: H
authors.lastname: Granstam-Björneklett
authors.forename: Mats
authors.initials: M
authors.lastname: Lekander
authors.forename: Bo
authors.initials: B
authors.lastname: Nilsson
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Ojutkangas
authors.forename: Anders
authors.initials: A
authors.lastname: Osterborg
authors.forename: Leif
authors.initials: L
authors.lastname: Bergkvist
authors.forename: Håkan
authors.initials: H
authors.lastname: Mellstedt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000276:immunology / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001943:Breast Neoplasms / Q000276:immunology* / Q000523:psychology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology / Q000523:psychology; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D020014:K562 Cells; D007694:Killer Cells, Natural / Q000187:drug effects / Q000276:immunology / Q000528:radiation effects; D008875:Middle Aged; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012657:Self-Help Groups; D015398:Signal Transduction; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents