Decongestion improves cell-mediated immunity in postmastectomy arm lymphoedema: a pilot study.

J Eur Acad Dermatol Venereol 2013 Dec 23;27(12):1579-82. Epub 2012 Jul 23.

Department of Dermatology and Allergology, Szeged University, Szeged, Hungary, and Dermatological Research Group, Hungarian Academy of Sciences, Szeged, Hungary.

Background: Chronic lymphoedematous limbs have an increased propensity for infections and primary or secondary malignant tumours. It has been attributed to suppressed delayed-type hypersensitivity measured in lymphoedemas related to Stewart-Treves syndrome, Kaposi's sarcoma or breast cancer treatment. Cell-mediated immunity is an effective defence mechanism against bacteria, fungi, viruses and tumour cells.

Objective: We aimed to examine whether decongestive lymphoedema therapy could improve cell-mediated immunity in breast cancer treatment-related lymphoedema (BCRL).

Methods: Eight women with unilateral BCRL were included in this study. At baseline, tuberculin skin test (TST) was performed on the volar surfaces of the forearms of the affected and non-affected sides using 0.5, 1 and 5 tuberculin units in the form of three consecutive injections with 3-cm spaces in-between, and arm volumes were measured using the Kuhnke's disc model. Decongestive lymphatic therapy was given to swollen arms in 10 consecutive working days. At the end of intensive decongestion, TST on affected side and bilateral volumetry were repeated.

Results: Baseline test using undiluted (5 units) and fivefold diluted (1 unit) tuberculin solutions has shown significant differences (P < 0.05) between the mean sizes (11.81 ± 2.32 and 7.75 ± 1.92; 7.12 ± 1.12 and 5.12 ± 0.91 respectively) in favour to healthy arms. Post therapeutically, the mean sizes were significantly increased (P < 0.05) in the dilutions of 1 : 1 and 1 : 5 (7.75 ± 1.92 and 10.56 ± 1.23 mm, 5.12 ± 0.91 and 5.93 ± 1.74 mm respectively).

Conclusion: Significant increase in TST sizes suggests that decongestive lymphatic therapy is able to partially restore impaired cellular immune function in BCRL.

Download full-text PDF

Source Listing

Still can't find the full text of the article?

We can help you send a request to the authors directly.
December 2013
16 Reads

Publication Analysis

Top Keywords

cell-mediated immunity
breast cancer
512 091
decongestive lymphatic
lymphatic therapy
775 192
solutions differences
bcrl included
included study
unilateral bcrl
disc model
bcrlmethods women
differences 005
women unilateral
tuberculin solutions
study baseline
skin test
test tst
fivefold diluted
diluted unit


(Supplied by CrossRef)
Immune cells in peripheral lymph and skin of patients with obstructive lymphedema
Olszewski et al.
Lymphology 1990
Syndrome de Stewart-Tréves avec deficit regional de l’immunité cellulare possible: hypothése pathogénique
Ruocco et al.
Ann Dermatol Venereol 1982
Linfostasi: importante fattore patogenetico nel sarcoma di Kaposi classic
Ruocco et al.
Ann Ital Dermatol Clin Sper 1992
Anomaies regionales de voies lymphatiques et de la réponse au D.N.C.B. dans le sarcoma de Kaposi classique
Ruocco et al.
Ann Dermatol Venereol 1985
The diagnosis and treatment of peripheral lymphoedema. 2009 Concensus Document of the International Society of Lymphology
International Society of Lymphology et al.
Lymphology 2009

Similar Publications