Neutrophil Function and the Effect of Chemotherapy on Neurophil Function in Patients with Cancer

It has been recognized for a long time that human malignant diseases are associated with immune deficiency states. Impaired phagocytic function, low levels of plasma opsonins, impaired bactericidal activity of granulocytes and macrophages, deficiency of myeloperoxydase, reduced migration of polymorphonuclear leukocytes and granulocytopenia have all been found in malignant condition primarily or secondarily.

Especially neutrophils are crucial to the body's defenses against infection. Defects in phagocytes can contribute to the local establishment and systemic spread of serious bacterial infection.

The authors studied neutrophil function in 40 control and 15 patients with acute myelogenous leukemia, 10 with non-Hodgkin's lymphoma, 40 with stomach cancer, 10 with hepatoma, 10 with pancreas cancer and 25 with other organ tumor to prove the mechanism of increased risk and the severity of infection using a battery of simple and reproducible neutrophil function tests as adherence to nylon wool fiber, migration under agarose method and nitrobule tetrazolium reduction test.

The results obtained are as follows;

1) On adherence to nylon wool fiber, the adherence was significantly decreased in patients with acute myelogenous leukemia, but increased in patients with lymphoma. In patients with other solid tumors, there were no significant differences from those of controls. After chemotherapy with Cisplatin and 5-FU, the adherence was significantly decreased than that of prior to therapy.

2) On migration under agarose, the chemotactic differential was significantly decreased in patients with acute myelogenous leukemia but increased in patients with hepatoma and pancreas cancer. Presence of factors of those increment was suspected. After infusion of Cisplatin, chemotactic differential was decreased significantly but after infusion of 5-FU, it was decreased but there was no significance.

3) On NBT reduction test, NBT reduction was diminished in patients with acute myelogenous leukemia but increased in patients with hepatoma and pancreas cancer. It is assumed that some unidentified factors would be present to enhance chemotaxis and NBT reduction in patients with hepatoma and pancreas cancer. After infusion of Cisplatin, NBT reduction was significantly decreased, but after infusion of 5-FU it was decreased but not significantly.

In patients with acute myelogenous leukemia, neutrophil functions were much impaired but in patients with solid tumors, there were no neutrophil function defects.

After chemotheraphy with Cisplatin and 5-FU, neutrophil functions were much compromised and this would predispose to increased risk of infection.