title: Immunological responses in a patient with glioblastoma multiforme treated with sequential courses of temozolomide and immunotherapy: case study.
abstract: Cytotoxic chemotherapy that induces lymphopenia is predicted to ablate the benefits of active antitumor immunization. Temozolomide is an effective chemotherapeutic agent for patients with glioblastoma multiforme, but it induces significant lymphopenia. Although there is monthly fluctuation of the white blood cell count, specifically the CD4 and CD8 counts, there was no cumulative decline in the patient described in this case report. Depriving patients of this agent, in order to treat with immunotherapy, is controversial. Despite conventional dogma, we demonstrated that chemotherapy and immunotherapy can be delivered concurrently without negating the effects of immunotherapy. In fact, the temozolomide-induced lymphopenia may prove to be synergistic with a peptide vaccine secondary to inhibition of regulatory T cells or their delayed recovery.
authors: Department of Neurosurgery, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA. aheimber@mdanderson.org
authors: Amy B
authors: AB
authors: Heimberger
authors: Wei
authors: W
authors: Sun
authors: S Farzana
authors: SF
authors: Hussain
authors: Mahua
authors: M
authors: Dey
authors: Lamonne
authors: L
authors: Crutcher
authors: Ken
authors: K
authors: Aldape
authors: Mark
authors: M
authors: Gilbert
authors: Samuel J
authors: SJ
authors: Hassenbusch
authors: Raymond
authors: R
authors: Sawaya
authors: Bob
authors: B
authors: Schmittling
authors: Gary E
authors: GE
authors: Archer
authors: Duane A
authors: DA
authors: Mitchell
authors: Darell D
authors: DD
authors: Bigner
authors: John H
authors: JH
authors: Sampson
mesh_terms: D018906:Antineoplastic Agents, Alkylating; D001932:Brain Neoplasms / Q000276:immunology* / Q000628:therapy*; D019496:Cancer Vaccines / Q000276:immunology / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives; D066246:ErbB Receptors / Q000276:immunology / Q000378:metabolism; D005434:Flow Cytometry; D005909:Glioblastoma / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D000077204:Temozolomide; D022223:Vaccines, Subunit
chemical_list: D018906:Antineoplastic Agents, Alkylating; D019496:Cancer Vaccines; D022223:Vaccines, Subunit; D003606:Dacarbazine; D066246:ErbB Receptors; D000077204:Temozolomide