Institution: | 1. Medical Oncology Unit II, Istituto Oncologico Veneto (IOV), IRCCS, Padova, Italy;2. Section of Oncology and Immunology, Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy;3. Department of Medicine-DiMED, Geriatric Section, University of Padova, Padova, Italy;4. Immunology and Molecular Oncology, Istituto Oncologico Veneto (IOV), IRCCS, Padova, Italy;5. Medical Oncology Unit I, Istituto Oncologico Veneto (IOV), IRCCS, Padova, Italy |
Abstract: | BackgroundThe challenge of immune senescence has never been addressed in elderly cancer patients. This study compares the thymic output and peripheral blood telomere length in ≥ 70 year old cancer patients.Patients and methodsFifty-two elderly cancer patients and 39 age-matched controls without personal history of cancer were enrolled. All patients underwent a Comprehensive Geriatric Assessment (CGA), from which a multidimensional prognostic index (MPI) score was calculated. Peripheral blood samples were studied for naïve and recent thymic emigrant (RTE) CD4+ and CD8+ cells by flow cytometry. T-cell receptor rearrangement excision circle (TREC) levels, telomere length and telomerase activity in peripheral blood cells were quantified by real-time PCR.ResultsThe percentages of CD8+ naïve and CD8+ RTE cells and TREC levels were significantly lower in cancer patients than in controls (p = 0.003, p = 0.004, p = 0.031, respectively). Telomere lengths in peripheral blood cells were significantly shorter in cancer patients than in controls (p = 0.046) and did not correlate with age in patients, whereas it did in controls (r = − 0.354, p = 0.031). Short telomere (≤ median)/low TREC (≤ median) profile was associated with higher risk of cancer (OR = 3.68 95% CI 1.22–11.11]; p = 0.021). Neither unfitness on CGA nor MPI score were significantly related to thymic output or telomere length in either group.ConclusionsImmune senescence is significantly worse in elderly cancer patients than in age-matched controls. The low thymic output and the shorter telomeres in peripheral blood cells of cancer patients may reflect a pre-existing condition which facilitates the onset of malignancies in elderly people. |