Evaluation of infectious complications and immune recovery following high-dose chemotherapy (HDC) and autologous peripheral blood progenitor cell transplantation (PBPC-T) in 148 breast cancer patients

Alberto Zambelli, Daniela Montagna, Gian Antonio Da Prada, Rita Maccario, Carlo Zibera, Antonia Moretta, Luisa Ponchio, Laura Lozza, Paola Baiardi, Renato Maserati, Pietro Marone, Gioacchino Robustelli della Cuna

Research output: Contribution to journalArticle

Abstract

Background and Objectives: High-dose chemotherapy (HDC) with autologus PBPC-T has been reported to be effective in hematological and in selected solid malignancies. In this setting, infectious complications represent a relevant cause of morbidity. Patients and Methods: To ascertain the incidence, types and factors influencing the development of early and late infections, we retrospectively analyzed 148 consecutive breast cancer (BC) patients receiving HDC and PBPC-T, both for primary high-risk BC (pBC) and metastatic disease (mBC). Results: Early infection strongly associated with the occurrence of grade 4 mucositis (p <0.001), was documented in 28 patients (19%). Late re-activation of varicella zoster virus (VZV) occurred in 14 patients (9%); an inverse correlation between the VZV re-activation and the total amount of T-cells transferred with the graft was observed. Evaluation of immune reconstitution, carried out in 10 out of 148 patients, showed a long-lasting CD+ T-cells depression (>2 year), mainly involving the naive CD4+ T-cell subset. Conversely, the analysis of the frequency of proliferating T-lymphocyte precursors, specific for antigens expressed by 3 different widespread pathogens, demonstrated that, notwithstanding the delayed recovery of CD4+ cells, many T-lymphocyte functions were within normal range 1 year after PBPC-T. Cunclusion: Altogether these results show that severe mucositis is associated with early bacterial infections and the infusion of large numbers of T-cells plays a role in controlling late VZV reactivation.

Original languageEnglish
Pages (from-to)3701-3708
Number of pages8
JournalAnticancer Research
Volume22
Issue number6 B
Publication statusPublished - Nov 2002

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Keywords

  • Breast cancer
  • High-dose chemotherapy
  • Infectious complications
  • Stem cells transplantation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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