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Neuro Oncol. 2008 Feb;10(1):98-103. Epub 2007 Dec 13.

Immunological responses in a patient with glioblastoma multiforme treated with sequential courses of temozolomide and immunotherapy: case study.

Author information

1
Department of Neurosurgery, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA. aheimber@mdanderson.org

Abstract

Cytotoxic chemotherapy that induces lymphopenia is predicted to ablate the benefits of active antitumor immunization. Temozolomide is an effective chemotherapeutic agent for patients with glioblastoma multiforme, but it induces significant lymphopenia. Although there is monthly fluctuation of the white blood cell count, specifically the CD4 and CD8 counts, there was no cumulative decline in the patient described in this case report. Depriving patients of this agent, in order to treat with immunotherapy, is controversial. Despite conventional dogma, we demonstrated that chemotherapy and immunotherapy can be delivered concurrently without negating the effects of immunotherapy. In fact, the temozolomide-induced lymphopenia may prove to be synergistic with a peptide vaccine secondary to inhibition of regulatory T cells or their delayed recovery.

PMID:
18079360
PMCID:
PMC2600844
DOI:
10.1215/15228517-2007-046
[Indexed for MEDLINE]
Free PMC Article

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