Pattern of CD4 T.lymphocyte Values in Cancer Patients on Cytotoxic Therapy

Abstract

Background: Assessment of patients prior to cytotoxic chemotherapy usually includes absolute neutrophils count. Other cellular markers of susceptibility to infection as well as immunocompetence include the T Helper lymphocyte count. In cancer patients, decrease in these  lymphocytes has been observed to be associated with decreased overall survival.

Aim: To assess the degree of CD4 lymphopenia encountered during cytotoxic chemotherapeutic treatment for cancer and evaluate the differences observed for the various drug combinations.

Subjects and Methods: Eighty patients with various histologically diagnosed malignancies had their CD4 lymphocyte counts carried out at days 0 and 12 of the first cycle of their various chemotherapeutic regimens. They were adult patients who had been diagnosed with breast cancer 36/80 cases (45%), non.Hodgkinfs lymphoma 8/80 cases (10%), Hodgkinfs lymphoma 13/80 cases (16.3%), multiple myeloma 7/80 cases (8.8%), colorectal carcinoma 6/80 cases (7.5%), and other malignancies 10/80 cases  (12.5%). CD4 lymphocyte count was done using the Partec CyflowR 2000 CD4 cell counter, and their socio.demographic data of the patients were assessed using a questionnaire.

Results: The mean (sd) CD4 lymphocyte count pre. and  post.chemotherapy was observed to be 567 (341)  cells/µLand 349 (207) cells/µL while the median values were 454  cells/µLand 349 cells/µL respectively. There were significant differences in CD4 lymphocyte counts after chemotherapy compared to the  pre.chemotherapy values.

Conclusion: Epirubicin combinations used in breast cancer patients as well as (Adriamycin, Bleomycin, Vinblastine,  Dacarbazine) ABVD regimen used in treatment of Hodgkinfs lymphoma were found to be significantly less lymphotoxic than other chemotherapeutic combinations. These drugs or their combinations may be less immunotoxic than other known regimen used for these  malignancies.

Keywords: Cancers, CD4 lymphocyte, Cytotoxic chemotherapy, Immunosuppression