Immune cell profiling of peripheral blood in long-term testicular germ cell tumor survivors.
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INTRODUCTION: This study addresses changes in peripheral blood immune cell composition and possible late effects of curative treatment in testicular germ cell tumors (GCT) survivors. METHODS: We analyzed the immunophenotype in peripheral blood obtained from 202 survivors treated at the National Cancer Institute in Bratislava by flow cytometry. The median long-term follow-up was 13 years (1-35). We divided the survivors into groups as follows: CT-chemotherapy (N = 141), RT-radiotherapy (N = 16), CTRT - chemotherapy + radiotherapy (N = 13), and the control group of patients under active surveillance - AS (N = 32). RESULTS: Survivors treated with AS had a lower number of B-cells (mean ± standard deviation (SD) = 10.3 ± 3.5 vs 11.9 ± 4.2, p=0.04) compared to the CT group. Survivors treated with AS vs RT had a higher number of total lymphocytes (29.8 ± 7.7 vs 25.2 ± 6.3, p=0.04). In AS vs CTRT group B-cells (10.3 ± 3.5 vs 13.7 ± 5, p=0.01) and conventional dendritic cells (cDCs) (74.3 ± 11.8 vs 82.5 ± 6.7, p=0.04) showed lower numbers. Survivors treated with AS vs. ≤ 400 mg/m2 cumulative dose of cisplatin had fewer eosinophils (2.29 ± 1.5 vs 2.99 ± 1.7, p=0.03) and double-negative T-cells (DNT cells) (4.7 ± 3.4 vs 6.6 ± 6.6, p=0.04). In AS vs. ≥ 400 mg/m2, B cells counts were lower in the control group (10.96 ± 5.3 vs 12.3 ± 4.8, p=0.03); treatment with ≤ 400 mg/m2 vs. ≥ 400 mg/m2 resulted in higher counts of eosinophils (3.0 ± 1.7 vs 2.1 ± 1.7, p=0.00025) and DNT cells (6.7 ± 6.7 vs 4.9 ± 3.6, p=0.02). CONCLUSIONS: Our study demonstrates an association between both cisplatin-based chemotherapy and radiotherapy with specific immune cell populations, suggesting that these treatment modalities may exert long-term immunomodulatory effects.