Immune impairment in patients with terminal cancers: influence of cancer treatments and cytomegalovirus infection

  • I-Hsuan Chen
  • Yuen-Liang Lai
  • Chien-Liang Wu
  • Yi-Fang Chang
  • Chen-Chung Chu
  • I-Fang Tsai
  • Fang-Ju Sun
  • Yen-Ta Lu
Original Article


Although immunodeficiency is usually considered a prerequisite of oncogenesis, a detailed immune profile in cancer has not yet been described. Without such profiling, it is not surprising that there is a vast discrepancy in the responses of cancer patients to immunotherapy. Our results show that the integrity of the immune system deteriorates with cancer progression by displaying a trend toward decreasing levels of functional T cells, including CD4, naïve, and central memory T cells, and an expansion of hyporesponsive populations such as CD28 and CMV-specific T cells. One hundred and one patients constitute the study group for the observational study reported in this paper. Forty-eight patients with newly diagnosed stages III and IV and 53 patients with extensively treated stage IV disease. The costimulatory molecules CD27 and CD28 were downregulated in all patients. Among the proinflammatory cytokines (IL-6, TNF-α, IFN-γ), only IL-6 differed significantly among the groups, increasing as the cancer stage progressed. Plasma IL-7 did not differ among the participants. The relative deficits of naïve T cells in cancer patients may be associated with the downregulation of IL-7Rα expression rather than changes in the circulating levels of IL-7. The downregulation of IL-7Rα expression was shown to be associated with increased levels of intracellular CMV. The present study suggests that the immune impairment in patients with cancer is associated with multiple factors, such as the stage of cancer, consequence of CMV infection and impact of treatment.


Immune profile Cancer Cytokines Cytomegalovirus Chemotherapy 



We thank to Dr. Mary Jeanne Buttrey for critical review and English revision of this manuscript. This study is supported by Mackay Memorial Hospital, under project MMH-E-96008 and NSC-97-2314-B-195-017.

Conflict of interest statement

None declared.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • I-Hsuan Chen
    • 1
  • Yuen-Liang Lai
    • 2
    • 3
    • 4
  • Chien-Liang Wu
    • 5
    • 7
  • Yi-Fang Chang
    • 6
  • Chen-Chung Chu
    • 1
  • I-Fang Tsai
    • 1
  • Fang-Ju Sun
    • 1
  • Yen-Ta Lu
    • 5
    • 7
  1. 1.Department of Medical ResearchMackay Memorial HospitalTaipeiTaiwan
  2. 2.Hospice Palliative Care CenterMackay Memorial HospitalTaipeiTaiwan
  3. 3.Center for General EducationNational Yang-Ming UniversityTaipeiTaiwan
  4. 4.School of MedicineTaipei Medical UniversityTaipeiTaiwan
  5. 5.Mackay MedicineNursing and Management CollegeTaipeiTaiwan
  6. 6.Hematology/Oncology Division, Medical DepartmentMackay Memorial HospitalTaipeiTaiwan
  7. 7.Chest Division, Medical DepartmentMackay Memorial HospitalTaipeiTaiwan

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