Lymphocyte depletion during treatment with intensive chemotherapy for cancer

Crystal L. Mackall, Thomas A. Fleisher, Margaret R. Brown, Ian T. Magrath, Aziza T. Shad, Marc E. Horowitz, Leonard H. Wexler, Melissa A. Adde, Linda L. McClure, Ronald E. Gress

Research output: Contribution to journalArticlepeer-review

307 Scopus citations


Recently we have observed an increased incidence of opportunistic infections in patients treated with intensive chemotherapy for cancer. Because T-cell depletion is associated with similar clinical events in human immunodeficiency virus infection and after bone marrow transplantation, we have analyzed peripheral blood lymphocyte populations in a series of patients during treatment with intensive chemotherapy for cancer. Although neutrophil, monocyte, and platelet numbers consistently recovered to greater than 50% of pretreatment values after each sequential cycle of therapy, lymphocyte numbers did not recover within the same time period. B cells decreased rapidly from a mean value of 149 ± 46/mm3 before chemotherapy to 4 ± 1/mm3 during chemotherapy (P = .01). CD4+ T cells decreased from a mean of 588 ± 76/mm3 before chemotherapy to 105 ± 28/mm3 during chemotherapy (P = .0002) and CD8+ T cells decreased from a mean of 382 ± 41/mm3 before chemotherapy to 150 ± 46/mm3 during chemotherapy (P = .0009). Natural killer cell numbers did not show significant declines (171 ± 30/mm3 before, 114 ± 24/mm3 during, P = .19). Based on the history of opportunistic complications in patients with other disorders who display similar degrees of CD4+ T-cell lymphopenia and preliminary observations in this population, immune incompetence could surface as a dose-limiting toxicity for highly dose-intensive chemotherapy regimens.

Original languageEnglish (US)
Pages (from-to)2221-2228
Number of pages8
Issue number7
StatePublished - Oct 1 1994

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology


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