title: Lymphocyte recovery after breast cancer treatment and mindfulness-based stress reduction (MBSR) therapy.
abstract: OBJECTIVE
  This randomized controlled trial was conducted to examine immune recovery following breast cancer (BC) therapy and evaluate the effect of mindfulness-based stress reduction therapy (MBSR) on immune recovery with emphasis on lymphocyte subsets, T cell activation, and production of T-helper 1 (Th1; interferon [IFN]-γ) and T-helper 2 (Th2; interleukin-4 [IL-4]) cytokines.
  
  
  METHODS
  Participants who completed the study consisted of 82 patients diagnosed with Stage 0-III BC, who received lumpectomy and adjuvant radiation ± chemotherapy. Patients were randomized into an MBSR(BC) intervention program or a control (usual care) group. Immune cell measures were assessed at baseline and within 2 weeks after the 6-week intervention. The numbers and percentages of lymphocyte subsets, activated T cells, and Th1 and Th2 cells in peripheral blood samples were determined by immunostaining and flow cytometry.
  
  
  RESULTS
  Immune subset recovery after cancer treatment showed positive associations with time since treatment completion. The B and natural killer (NK) cells were more susceptible than T cells in being suppressed by cancer treatment. Women who received MBSR(BC) had T cells more readily activated by the mitogen phytohemagglutinin (PHA) and an increase in the Th1/Th2 ratio. Activation was also higher for the MBSR(BC) group if <12 weeks from the end of treatment and women in MBSR(BC) <12 weeks had higher T cell count for CD4(+).
  
  
  CONCLUSIONS
  MBSR(BC) promotes a more rapid recovery of functional T cells capable of being activated by a mitogen with the Th1 phenotype, whereas substantial recovery of B and NK cells after completion of cancer treatment appears to occur independent of stress-reducing interventions.
authors.affiliation: College of Nursing, University of South Florida, Tampa, FL, USA. clengacha@health.usf.edu
authors.forename: Cecile A
authors.initials: CA
authors.lastname: Lengacher
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Janice
authors.initials: J
authors.lastname: Post-White
authors.forename: Shirley
authors.initials: S
authors.lastname: Fitzgerald
authors.forename: Cathy
authors.initials: C
authors.lastname: Newton
authors.forename: Michelle
authors.initials: M
authors.lastname: Barta
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Shelton
authors.forename: Manolete
authors.initials: M
authors.lastname: Moscoso
authors.forename: Versie
authors.initials: V
authors.lastname: Johnson-Mallard
authors.forename: Eleanor
authors.initials: E
authors.lastname: Harris
authors.forename: Loretta
authors.initials: L
authors.lastname: Loftus
authors.forename: Charles
authors.initials: C
authors.lastname: Cox
authors.forename: Nancy
authors.initials: N
authors.lastname: Le
authors.forename: Matthew
authors.initials: M
authors.lastname: Goodman
authors.forename: Julie
authors.initials: J
authors.lastname: Djeu
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Widen
authors.forename: Barry B
authors.initials: BB
authors.lastname: Bercu
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Klein
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000097:blood* / Q000523:psychology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets; D008875:Middle Aged; D013315:Stress, Psychological / Q000628:therapy*