Lymphocyte function following radium-223 therapy in patients with metastasized, castration-resistant prostate cancer

  • Vahé Barsegian
  • Stefan P. Müller
  • Daniel Möckel
  • Peter A. Horn
  • Andreas Bockisch
  • Monika LindemannEmail author
Original Article



Therapy with the alpha-emitter radium-223 chloride (223Ra) is an innovative therapeutic option in patients with metastasized, castration-resistant prostate cancer. However, radiotherapy can lead to hematopoietic toxicity. The aim of this study was to determine if 223Ra therapy induces an impairment of cellular antimicrobial immune responses.


In 11 patients receiving 223Ra treatment, lymphocyte proliferation and the production of pro- and anti-inflammatory cytokines (interferon-γ and interleukin-10) were determined, using lymphocyte transformation testing and ELISpot, respectively. Lymphocyte function after stimulation with mitogens and microbial antigens was assessed prior to therapy and at day 1, 7 and 28 after therapy.


Lymphocyte proliferation and the production of interferon-γ and interleukin-10 towards mitogens and antigens remained unchanged after therapy. Consistent with these in vitro data, we did not observe infectious complications after treatment.


The results argue against an impairment of lymphocyte function after 223Ra therapy. Thus, immune responses against pathogens should remain unaffected.


Radium-223 therapy Antimicrobial immune response Lymphocyte proliferation ELISpot Cytokine 



The authors would like to thank Monika Huben and Martina Praast for their excellent technical assistance.

Authors’ contributions

M.L., V.B., S.P.M., P.A.H. and A.B. contributed to the conception and design of the study. V.B. and M.L. wrote the report. V.B. and D.M. recruited the patients and took blood samples. M.L. and V.B. performed the cellular in vitro assays. All authors read and approved the final manuscript.

Compliance with ethical standards


This study was performed without external funding.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Institute of Nuclear MedicineHelios KlinikenSchwerinGermany
  2. 2.Department of Nuclear MedicineUniversity Hospital EssenEssenGermany
  3. 3.Institute for Transfusion MedicineUniversity Hospital EssenEssenGermany

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