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Drug-induced modulation of T lymphocytes as a potential mechanism of susceptibility to infections in patients with multiple myeloma during bortezomib therapy.

Li J, Li Y, Huang B, Zheng D, Chen M, Zhou Z - Cell Biochem. Biophys. (2015)

Bottom Line: The T lymphocyte numbers significantly decreased after bortezomib therapy (p < 0.05), and the same was true for the Th1/Th2 ratio (p < 0.01).Patients with MM who have decreased lymphocyte counts, while on bortezomib therapy are more likely to develop bacterial or viral infections.In addition, an imbalance in T lymphocyte subsets is also associated with bacterial or viral infections in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China, lijuan_guangzhou@163.com.

ABSTRACT
Bortezomib is effective in the therapy of multiple myeloma (MM), but causes infections that are different from those associated with conventional chemotherapy. It is important to identify the risk factors that facilitate infections associated with bortezomib therapy. In the present report, we sought to (1) define the features of the infections associated with this therapy and (2) identify the immune mechanisms responsible for the observed susceptibility to these infections. We first retrospectively analyzed the clinical data of 143 patients who had received bortezomib therapy for MM. We then prospectively assessed the modulation of T lymphocyte status during this therapy, and evaluated potential relationships between infections and T lymphocyte changes. The infection rates peaked during the first cycle of bortezomib therapy (47.6%) in patients with MM (p < 0.05 vs. subsequent cycles). Bortezomib therapy was associated with higher incidence rates of viral and fungal infections (15.8%, p < 0.05 vs. conventional chemotherapy). In addition, patients with the IgG immunophenotype showed higher bacterial and viral infection rates (respectively, p = 0.008 and 0.009). The T lymphocyte numbers significantly decreased after bortezomib therapy (p < 0.05), and the same was true for the Th1/Th2 ratio (p < 0.01). Patients with MM who have decreased lymphocyte counts, while on bortezomib therapy are more likely to develop bacterial or viral infections. In addition, an imbalance in T lymphocyte subsets is also associated with bacterial or viral infections in these patients.

No MeSH data available.


Related in: MedlinePlus

Changes in Th and CTL lymphocytes following the bortezomib therapy. * p < 0.05; ** p < 0.01
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Fig9: Changes in Th and CTL lymphocytes following the bortezomib therapy. * p < 0.05; ** p < 0.01

Mentions: A further analysis of T lymphocyte subsets showed decreased counts of the Th, CTL, and Treg subsets in the bortezomib group during the first, second, and forth cycles,compared with the baseline (p < 0.05; Fig. 9). Based on the secreted cytokines and functions, Th cells were divided into the Th1, Th2, and Th17 subsets. Following the dynamic monitoring and analysis, the lowest Th1/Th2 ratio and Treg counts were observed after the first cycle of bortezomib therapy (p < 0.01), while the lowest Th1/Th17 ratio was found after the forth cycle (p = 0.007; Fig. 10).Fig. 9


Drug-induced modulation of T lymphocytes as a potential mechanism of susceptibility to infections in patients with multiple myeloma during bortezomib therapy.

Li J, Li Y, Huang B, Zheng D, Chen M, Zhou Z - Cell Biochem. Biophys. (2015)

Changes in Th and CTL lymphocytes following the bortezomib therapy. * p < 0.05; ** p < 0.01
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4289524&req=5

Fig9: Changes in Th and CTL lymphocytes following the bortezomib therapy. * p < 0.05; ** p < 0.01
Mentions: A further analysis of T lymphocyte subsets showed decreased counts of the Th, CTL, and Treg subsets in the bortezomib group during the first, second, and forth cycles,compared with the baseline (p < 0.05; Fig. 9). Based on the secreted cytokines and functions, Th cells were divided into the Th1, Th2, and Th17 subsets. Following the dynamic monitoring and analysis, the lowest Th1/Th2 ratio and Treg counts were observed after the first cycle of bortezomib therapy (p < 0.01), while the lowest Th1/Th17 ratio was found after the forth cycle (p = 0.007; Fig. 10).Fig. 9

Bottom Line: The T lymphocyte numbers significantly decreased after bortezomib therapy (p < 0.05), and the same was true for the Th1/Th2 ratio (p < 0.01).Patients with MM who have decreased lymphocyte counts, while on bortezomib therapy are more likely to develop bacterial or viral infections.In addition, an imbalance in T lymphocyte subsets is also associated with bacterial or viral infections in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China, lijuan_guangzhou@163.com.

ABSTRACT
Bortezomib is effective in the therapy of multiple myeloma (MM), but causes infections that are different from those associated with conventional chemotherapy. It is important to identify the risk factors that facilitate infections associated with bortezomib therapy. In the present report, we sought to (1) define the features of the infections associated with this therapy and (2) identify the immune mechanisms responsible for the observed susceptibility to these infections. We first retrospectively analyzed the clinical data of 143 patients who had received bortezomib therapy for MM. We then prospectively assessed the modulation of T lymphocyte status during this therapy, and evaluated potential relationships between infections and T lymphocyte changes. The infection rates peaked during the first cycle of bortezomib therapy (47.6%) in patients with MM (p < 0.05 vs. subsequent cycles). Bortezomib therapy was associated with higher incidence rates of viral and fungal infections (15.8%, p < 0.05 vs. conventional chemotherapy). In addition, patients with the IgG immunophenotype showed higher bacterial and viral infection rates (respectively, p = 0.008 and 0.009). The T lymphocyte numbers significantly decreased after bortezomib therapy (p < 0.05), and the same was true for the Th1/Th2 ratio (p < 0.01). Patients with MM who have decreased lymphocyte counts, while on bortezomib therapy are more likely to develop bacterial or viral infections. In addition, an imbalance in T lymphocyte subsets is also associated with bacterial or viral infections in these patients.

No MeSH data available.


Related in: MedlinePlus