Adjuvan kemoterapi alan erken evre meme kanserli hastalarda lenfosit alt tiplerinin flow sitometrik analizi

Amaç: Adjuvan kemoterapiler erken evre meme kanserinde nüks riskini azaltırken doğal immüniteyi etkileyerek ciddi morbiditeye yol açarlar; ancak kazanılmış immünite üzerindeki etkileri daha az bilinmektedir. Bu çalışmada, erken evre meme kanseri nedeniyle kemoterapi alan hastalarda hücresel immünitenin yenilenmesini akım sitometrisiyle değerlendirmeyi amaçladık. Yöntem ve Gereç: Çalışmaya 42 hasta katıldı. Kemoterapi öncesi ve sonrası 3., 6., ve 12. aylarda periferik kan örnekleri toplandı. Anti-CD3, CD4, CD8, CD16, CD19 ve CD56 monoklonal antikorları kullanılarak T-lenfosit, Blenfosit ve Naturel Killer (NK) hücre sayıları saptandı. Bulgular: CD19 B lenfositler kemoterapi sonrası 3. ayda bazal değerlere göre belirgin olarak azalmış iken 6. ayda çoğu hastada bazal değerlere ulaştığı görüldü . CD4 T hücreler 3. ve 6. aylarda bazal değerlere göre belirgin azalmış idi; 12. ayda çoğu hastada normal değerlere yaklaştı. CD8 T hücre sayıları 3. ayda bazal değerlere göre belirgin azalmış idi. Altıncı ve 12. aylarda ise ortalama normal değerlere göre farklı değildi. NK hücre sayıları 3. ve 6. aylarda bazal değerlere göre belirgin olarak azdı. 12. ayda ise normale göre düşük olmakla birlikte aradaki fark istatistiksel olarak anlamlı değildi. Sonuç: Kemoterapi, 12 ay sonrasına kadar hücresel immün sistem üzerindeki baskılayıcı etkilerini sürdürmektedir. İmmün sistem baskılanmasının enfeksiyöz hastalıkların sıklığında ve kanser nüks riskinde oluşturabileceği muhtemel artış yeterli istatistiki güce sahip çalışmalarda araştırılmalıdır.

Analysis of lymphocyte subtypes by flow cytometry after adjuvant chemotherapy for early-stage breast cancer

Aim: Adjuvant chemotherapy decreases the risk of relapse in early breast cancer. Impairment of innate immunity with chemotherapy is associated with significant morbidity; however the effect of chemotherapy on adaptive immunity is not fully known. In this study, we aimed at determining the recovery of cellular immunity by flow cytometry in patients receiving adjuvant chemotherapy for early-stage breast cancer. Material and Methods: Forty-two patients were studied. Peripheral blood samples were collected before and at 3, 6 and 12 months after chemotherapy. Anti-CD3, CD4, CD8, CD16, CD19 and CD56 monoclonal antibodies were used to determine T-, B- and NK- cell subsets. Results: While CD19+ B cell numbers at 3 months after chemotherapy were significantly lower than baseline, they returned to normal at 6 months in most patients. CD4+ T cell numbers were significantly lower than baseline at 3 and 6 months postchemotherapy. T cells recovered in most patients by 12 months. CD8+ T cells were low at 3 months; however, they were not significantly different than baseline at 6 and 12 months postchemotherapy. NK cell numbers were significantly lower than baseline at 3 and 6 months. At 12 months, they were numerically lower than baseline, although the difference was not statistically significant. Conclusion: Recovery of the cellular immune system is delayed up to 12 months postchemotherapy. Potential implications of delayed immune recovery on infectious diseases and risk of relapse should be investigated in studies with adequate statistical power.

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