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The impact of leukapheresis on immune-cell number and function in patients with advanced cancer

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Abstract

Background

Leukapheresis is often performed in cancer patients to harvest stem cells, manufacture therapeutic vaccines, or follow immunologic response to therapy. We have recently described the minimal impact of leukapheresis on normal donors. Here we provide additional immunologic data from patients with advanced cancer who underwent leukapheresis.

Methods

Using data from cancer patients on clinical trials who had leukapheresis (n = 64) or peripheral blood draws only (n = 90) as controls for immune analysis, we evaluated the impact of leukapheresis on number and function of lymphocytes.

Results

In the leukapheresis group, median age was 63.5 (range 38–82); 87.5 % were male. Comparing pre- and post-leukapheresis values within the groups, with each patient as its own control, there was no significant difference in enzyme-linked immunosorbent spot (ELISPOT), antivector humoral response, absolute lymphocyte count (ALC), or T cell number. Twelve patients completed three leukaphereses with subsequent ELISPOT analysis; seven had increased responses to flu (1.1- to 2.3-fold) with an even distribution around no change. Nineteen patients had matched ALC values after completing three leukaphereses with no significant change from baseline.

Conclusions

These data provide evidence that leukapheresis has no detectable effects on a cancer patient’s immune system in terms of number or function. These results contribute to a growing body of evidence refuting the hypothesis that a patient’s immune competence is meaningfully affected by the procedure. Limitations include a restriction to 2-L leukapheresis procedure and small sample size.

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Abbreviations

ALC:

Absolute lymphocyte count

CAP:

College of American Pathologists

CLIA:

Clinical Laboratory Improvement Act

ELISA:

Enzyme-linked immunosorbent assay

ELISPOT:

Enzyme-linked immunosorbent spot

FDA:

US Food and Drug Administration

IFN-γ:

Interferon-gamma

IgG:

Immunoglobulin G

NIH:

National Institutes of Health

OS:

Overall survival

PBMCs:

Peripheral blood mononuclear cells

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Acknowledgments

The authors acknowledge the Intramural Research Program of the National Institutes of Health (NIH), National Cancer Institute (NCI), Center for Cancer Research for their support of this study. We also express appreciation to the professionals at the NIH Clinical Center Department of Transfusion Medicine for their part in performing apheresis procedures in study patients and to the medical oncology fellows at the NCI for their attention to patient care. Finally, we thank Bonnie L. Casey and Debra Weingarten for their editorial assistance in the preparation of this manuscript. This research was supported by the Intramural Research Program of the Center for Cancer Research, National Cancer Institute, National Institutes of Health.

Author information

Authors and Affiliations

  1. Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    James L. Gulley, Jennifer Marté & Ravi A. Madan

  2. Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    James L. Gulley, Christopher R. Heery, Kwong Y. Tsang & Jeffrey Schlom

  3. Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA

    Seth M. Steinberg

  4. Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD, USA

    Susan F. Leitman

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  1. James L. Gulley
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  2. Jennifer Marté
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  3. Christopher R. Heery
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Correspondence to James L. Gulley.

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Gulley, J.L., Marté, J., Heery, C.R. et al. The impact of leukapheresis on immune-cell number and function in patients with advanced cancer. Cancer Immunol Immunother 64, 1429–1435 (2015). https://doi.org/10.1007/s00262-015-1738-9

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  • DOI: https://doi.org/10.1007/s00262-015-1738-9

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