Doctoral theses
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Current Record: 1994 of 2435
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| Identifier |
343442 |
| Title |
Μελέτη της δράσης των αιμοποιητικών παραγόντων GM-CSF και GCSF στο λεμφοκυτταρικό σύστημα κατα την φάση της μυελικής ανάπλασης |
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Author
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Σάρρα, Ευανθία Ελ
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| Abstract |
Chemotherapy-induced myelosuppression is frequently treated with the hematopoietic growth factors rhGM-CSF or rhG-CSF which promote bone marrow regeneration. However, the effect of the administration of these growth factors on lymphopoiesis during bone marrow regeneration , causes functional disturbances of T-and B- lymphocytes. In this study, 53 chemotherapy – naive patients with histologically or cytologically confirmed solid tumors who developed grade 3 or 4 leukopenia, were treated with hematopoietic growth factors until bone marrow recovery. In addition 38 chemotherapy patients with different solid tumors who developed grade 3 or 4 leukopenia during the first cycle of chemotherapy were randomized to receive either rhG-CSF or rhGM-CSF. In all patients the regeneration of T, B and NK-lymphocytes was analyzed by indirect immunofluorescence. Moreover, in some patients the function of T-lymphocyte subsets was also studied using in vitro proliferation assays.
During the phase of post –chemotherapy myelosuppression, 26% of the patients presented a severe lymphopenia p<400cells/dl) .Both T-,B- and NK cells were affected. Moreover, 31 out of 53(58%)patients presented severe CD4+ lymphopenia (p<400cells/dl). The administration of growth factors and the regeneration of bone marrow was associated with an active lympopoiesis which was characterized by a significant increase of T-,B- and NK-cells. All T- cell subsets were significantly increased during this phase. The administration of rhG-CSF or rhGM-CSF did not resulted in phenotypic differences of T-lymphocytes . In addition, during the phase of bone marrow regeneration a significantly increase of the absolute number of IL2-R+(CD25+)and HLA-DR+cells was observed; double staining phenotypic analysis revealed that these activation molecules were mainly expressed on CD4+ but also on CD8+cells. In addition in 4/12 (25%) patients,increased serum levels of IL2 were detected whereas in 9/15(60%) patients peripheral blood mononuclear cells were able to proliferate in vitro in the absence of any growth factor or mitogenic stimulation. Despite the active lymphopoiesis during bone marrow regeneration 11 out of 53 patients still presented CD4+ lymphopenia at the time of bone marrow recovery. Five cases of opportunistic infections were observed in these patients .Therefore, all these data support the hypothesis that chemotherapy may induce severe CD4+ lymphopenia and functional defects of lymphocytes which may be responsible for the development of opportunistic infections.
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| Language |
Greek |
| Subject |
Hematopoietic Cell Growth Factors |
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Hemic and Lymphatic Systems |
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Lymphocytes |
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Αίμα και λεμφικό σύστημα |
| Issue date |
2004-03-01 |
| Collection
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School/Department--School of Medicine--Department of Medicine--Doctoral theses
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Type of Work--Doctoral theses
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| Permanent Link |
https://elocus.lib.uoc.gr//dlib/b/1/2/metadata-dlib-2004DIS0301.tkl
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| Views |
297 |
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