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Immune response, depression and fatigue in relation to support intervention in mammary cancer patients

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Goal of work

To study the effect of support intervention on immune function in breast cancer patients.

Materials and methods

Breast cancer patients from an ongoing prospective randomised quality-of -life study were chosen for assaying immune functions in relation to a support-group intervention program running on a residential basis. Twenty-one women received adjuvant-combined radio-chemotherapy (CT-RT) and 20 women radiotherapy (RT). Eleven CT-RT and ten RT patients were randomised to support-group intervention, the rest served as controls. Immune tests for NK cells and NK-cell cytotoxicity, as well as lymphocyte subpopulations and response to antigen were performed before intervention, 2, 6, and 12 months later, in parallel to controls and healthy volunteers (n = 11). Depression, anxiety and fatigue were evaluated by the Hospital Anxiety and Depression (HAD) and the Norwegian Fatigue questionnaire. The density of NK cell receptors and in vitro quantitation of functional NK cytotoxicity against K562 cell line were evaluated. Four-colour flow cytometry was used to detect signal transduction molecules and cytokine expression. T-cell proliferate response to purified protein derivate (PPD) antigen was evaluated.

Results

No significant immune effect of support intervention could be found. The immune variables were severely disarranged compared to healthy volunteers but showed a statistically significant improvement over time. The majority of patients suffered from fatigue but had low scores for depression and anxiety.

Conclusion

No effect on immune parameters could be detected from support intervention. The long-lasting immune suppression might override a putative effect of the intervention. Low depression scores may contribute to the absence of a detectable effect.

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Acknowledgement

Special thanks to the breast cancer patients, the staff from Västerås Hospital, the staff at The Foundation of Lustgården Mälardalen Cancer Support for making this study possible and Birgitta Hagström for excellent technical assistance. The study was supported by grants from the Research Foundation of Sparbanks-Stiftelsen Nya, The Cancer and Allergy Foundation, Cancer and Traffic Injury Fund and the County Council of Västmanland.

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Authors and Affiliations

  1. Immune and Gene Therapy Laboratory, Cancer Centre Karolinska, Karolinska University Hospital Solna, 17176, Stockholm, Sweden

    Christina Lindemalm, Fariba Mozaffari, Aniruddha Choudhury, Anders Österborg & Håkan Mellstedt

  2. Department of Oncology, Central Hospital, 72189, Västerås, Sweden

    Helena Granstam-Björneklett

  3. Department of Clinical Neuroscience, Osher Center for Integrative Medicine and Section of Psychology, Karolinska Institutet, 17177, Stockholm, Sweden

    Mats Lekander

  4. Department for Cancer Epidemiology, Karolinska University Hospital, 17176, Stockholm, Sweden

    Bo Nilsson

  5. Centre for Clinical Research, Uppsala University, Central Hospital, 72189, Västerås, Sweden

    Marja-Leena Ojutkangas & Leif Bergkvist

  6. Departments of Haematology and Oncology, Karolinska University Hospital, Stockholm, Sweden

    Anders Österborg & Håkan Mellstedt

  7. Department of Surgery, Central Hospital, 72189, Västerås, Sweden

    Leif Bergkvist

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  1. Christina Lindemalm
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  2. Fariba Mozaffari
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Correspondence to Christina Lindemalm.

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Lindemalm, C., Mozaffari, F., Choudhury, A. et al. Immune response, depression and fatigue in relation to support intervention in mammary cancer patients. Support Care Cancer 16, 57–65 (2008). https://doi.org/10.1007/s00520-007-0275-2

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  • DOI: https://doi.org/10.1007/s00520-007-0275-2

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