Influence of R-CHOP Therapy on Immune System Restoration in Patients with B-Cell Lymphoma.
OBJECTIVE
To assess the immunosuppressive effect of R-CHOP in patients with B-cell lymphoma at 2 years.


METHODS
Parameters of humoral and cell-mediated immunity were assessed in 89 patients with diffuse large B-cell lymphoma or follicular lymphoma before and after 6-8 cycles of R-CHOP-14 or R-CHOP-21 regimen.


RESULTS
Data on pre- and posttreatment serum IgG (sIgG) levels were available for all 89 patients, while the corresponding data on serum CD20+, CD3+, CD4+, and CD8+ lymphocyte counts were available in only 43. Median sIgG levels significantly decreased from 1,221 mg/dl (baseline) to 733 mg/dl (after chemotherapy) (p < 0.001). Although CD20+ and CD4+ cell counts decreased (p < 0.001), no significant effect of chemotherapy on CD3+ and CD8+ cell counts was observed. CD20+ cell counts were restored to baseline levels at the 12-month follow-up. sIgG levels and CD4+ cell counts were not completely restored at 24 months, indicating a sustained immunosuppressive effect of R-CHOP in these patients. The incidence of infections over the 2-year period was 16.3-23.6%.


CONCLUSIONS
The immunosuppressive effect of R-CHOP in newly diagnosed cases of B-cell lymphoma tends to persist for >2 years, although sIgG levels were restored more quickly than CD4+ cell counts.
Department of Pharmacy, Fujita Health University Hospital, Aichi, Japan.
Kaori
K
Ito
Masataka
M
Okamoto
Yoko
Y
Inaguma
Akinao
A
Okamoto
Maiko
M
Ando
Yosuke
Y
Ando
Masahiro
M
Tsuge
Ayana
A
Tomono
Yukiko
Y
Kakumae
Takahiro
T
Hayashi
Shigeki
S
Yamada
Nobuhiko
N
Emi
D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D018951:Antigens, CD20 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000276:immunology* / Q000494:pharmacology*; D017252:CD3 Complex / Q000032:analysis; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000187:drug effects*; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007239:Infections / Q000139:chemically induced; D016393:Lymphoma, B-Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D000069283:Rituximab / Q000008:administration & dosage; D013601:T-Lymphocytes / Q000737:chemistry / Q000187:drug effects*; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D017252:CD3 Complex; D007074:Immunoglobulin G; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
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