ASPO Abstracts
Psychological Distress and Immune Alterations in Patients with Indolent B-cell-derived Neoplasms
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Purpose: Some subtypes of leukemias, lymphomas, and myelomas are slow-growing a
and can be clinically managed with surveillance until symptoms emerge; however, many p
patients report elevated levels of distress and worry during the surveillance phase. P
Psychological distress may have clinical implications given that natural killer (NK) and T c
cells are not only sensitive to distress, but also critical in controlling disease progression. T
Thus, the purpose of this study was to examine associations between psychological and i
immune factors in patients with indolent blood cell cancer being managed with s
surveillance.
Methods: 227 patients diagnosed with low-grade B-cell-derived neoplasms not requiring
immediate therapy were enrolled. At study entry, participants completed the Hospital
Anxiety and Depression Scale (HADS) and provided a blood sample for immune
phenotyping using multiparametric flow cytometry (up to 12-color). Biomarkers of a
activation, viability, proliferation, and exhaustion were assessed on subsets of T, NK, and m
myeloid cells, and the percentage of cells staining for individual biomarkers were d
determined. Immunophenotyping has been completed for the first 115 patients enrolled (
(62 males; mean age = 64.3 years) and are presented below.
Results: Spearman correlation analyses revealed that higher levels of anxiety and
depressive symptoms were associated with greater % of classical (CD14++CD16-)
monocytes, the subgroup that produces IL-6, IL-8, and IL-10, is highly phagocytic, and
expresses proliferative/anti-apoptotic genes (p < 0.02); but negatively associated with %
of non-classical (CD14+CD16+) monocytes, the subgroup that produces TNF-alpha and
IL-1beta, exhibits “patrolling” behavior and has anti-proliferative/pro-apoptotic properties (
(p < 0.01). Higher anxiety and depressive symptoms were also associated with lower NK c
cell viability in blood (p ≤ 0.04).
Conclusion: In patients with indolent blood cell cancer, psychological distress is
associated with altered immune function, notably differential patterns of monocyte
distribution and greater susceptibility of NK cells to activation-induced apoptosis. These
findings may have direct translational relevance and enable the early identification of
patients at-risk for disease progression and poor outcomes.
Keywords: Distress, non-Hodgkin lymphoma, watch Hodgkin lymphoma, watch-and and-wait, NK cells