title: Treatment with lenalidomide modulates T-cell immunophenotype and cytokine production in patients with chronic lymphocytic leukemia.
abstract: BACKGROUND
  Lenalidomide, an immunomodulatory agent, has activity in lymphoproliferative disorders. The authors, therefore, evaluated its effects on T-cell immunophenotype and cytokine production in patients with chronic lymphocytic leukemia (CLL).
  
  
  METHODS
  To study the immunomodulatory effects of lenalidomide in CLL, the authors recruited 24 patients with untreated CLL enrolled in a phase 2 clinical trial of lenalidomide and obtained peripheral blood specimens for immunologic studies consisting of enumeration of T cells and assessing their ability to synthesize cytokines after activation through T-cell receptor (TCR).
  
  
  RESULTS
  After 3 cycles of therapy, patients had a significant reduction in percentage (%) and absolute lymphocyte count (ALC) and an increase in percentage of T cells, percentage of activated CD8(+) T cells producing IFN-γ, and percentage of regulatory T (T(R) ) cells when compared with their respective levels before treatment. After 15 cycles of treatment, responder patients had significant reduction in percentage of lymphocytes and ALC, percentage of activated CD4(+) T cells producing IL-2, IFN-γ, or TNF-α, and percentage of T(R) cells when compared with their perspective levels after 3 cycles of treatment. Furthermore, the numbers of activated CD4(+) T cells producing IL-2, IFN-γ, or TNF-α, activated CD8(+) T cells producing IFN-γ, and T(R) cells normalized to the range of healthy subjects.
  
  
  CONCLUSIONS
  Treatment with lenalidomide resulted in the normalization of functional T-cell subsets in responders, suggesting that lenalidomide may modulate cell-mediated immunity in patients with CLL.
authors.affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Bang-Ning
authors.initials: BN
authors.lastname: Lee
authors.forename: Hui
authors.initials: H
authors.lastname: Gao
authors.forename: Evan N
authors.initials: EN
authors.lastname: Cohen
authors.forename: Xavier
authors.initials: X
authors.lastname: Badoux
authors.forename: William G
authors.initials: WG
authors.lastname: Wierda
authors.forename: Zeev
authors.initials: Z
authors.lastname: Estrov
authors.forename: Stefan H
authors.initials: SH
authors.lastname: Faderl
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Keating
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ferrajoli
authors.forename: James M
authors.initials: JM
authors.lastname: Reuben
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D002986:Clinical Trials as Topic / Q000451:nursing; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016130:Immunophenotyping; D007376:Interleukin-2 / Q000276:immunology; D000077269:Lenalidomide; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D016207:Cytokines; D007155:Immunologic Factors; D007376:Interleukin-2; D013792:Thalidomide; D000077269:Lenalidomide