Decreased functional T lymphocyte-mediated cytokine responses in patients with chemotherapy-induced neutropenia

Objectives The degree of immunosuppression in patients with haematological malignancies treated with chemotherapy is routinely measured as number of circulating cells (preferable neutrophils) in peripheral blood. A parallel decline in the number of T cells is expected, but a possible alteration in their functionality has been less well explored. The ability of T cells to secrete more than one cytokine simultaneously is known to indicate protective immunity. The aim of this study was to determine whether the function of circulating T cells is altered in patients with chemotherapy-induced neutropenia. Design, setting and subjects In this cross-sectional study, we used the FluoroSpot assay to investigate the proportion of T cells secreting either interferon- or interleukin-2, or both cytokines simultaneously, after anti-CD3 stimulation. Peripheral blood mononuclear cells from 53 adult patients with chemotherapy-induced neutropenia and 20 healthy individuals were investigated. Results There were significantly fewer T cells secreting interferon- in patients with neutropenia compared with healthy control subjects (P=0.02), but the difference was greatest for dual cytokine-secreting T cells (P=0.001). Furthermore, the amount of secreted cytokine per T cell appeared to be reduced in patients, compared with control subjects. Conclusion Our results suggest that the functionality of T cells is altered in patients with haematological malignancies with chemotherapy-induced neutropenia. In parallel with a decline in T cell count, this may further increase the risk of severe infections.