# Mitigating High Grade Radiation-Induced Lymphopenia through Pretreatment Autologous Lymphocyte Infusion

> **NIH NIH R21** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2021 · $176,175

## Abstract

PROJECT SUMMARY
Radiation induced lymphopenia (RIL) is a common radiation-related toxicity that has been recognized for over
a century but often ignored as clinically inconsequential. However, accumulating evidence has demonstrated
strong association of high grade RIL (seen in 30-50% of patients) with poor prognosis. The pervasive role of
radiotherapy in the curative management of solid tumors supports the need to develop mitigating strategies,
particularly for patients with a high risk of developing grade 4 (G4) RIL. We have compelling evidence from
both clinical and preclinical work that severe RIL impacts cancer control and therapy effectiveness, and
methods to reduce RIL may improve treatment outcomes. To further develop these approaches for clinical
translation, we have proposed 2 specific aims. In aim 1, we will build on our initial prediction model for G4 RIL
and leverage our large database of esophageal cancer patients who have completed chemoradiation (CRT) to
develop a better predictive model for G4 RIL so that we can rapidly and efficiently identify the highest risk
patients for mitigating strategies. In aim 2, we will determine the feasibility and safety of raising the baseline
lymphocyte levels by autologous lymphocyte infusion (ALI) prior to initiating CRT. Fundamentally, this
research will allow us to develop the necessary computational tool capable of properly identifying patients at
risk for developing severe RIL, and complete a small feasibility and safety study of using ALI as a way to raise
the baseline pre-treatment lymphocyte levels so that the probability of developing G4 RIL could be possibly
curtailed. By targeting the at-risk patients to receive RIL mitigating strategies, we will hopefully be able to
improve the cancer outcomes of standard cancer therapies, and build on current innovative strategies of
immunotherapy and radiation combinations.

## Key facts

- **NIH application ID:** 10017926
- **Project number:** 5R21CA240881-02
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Gheath Al-Atrash
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $176,175
- **Award type:** 5
- **Project period:** 2019-09-13 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017926

## Citation

> US National Institutes of Health, RePORTER application 10017926, Mitigating High Grade Radiation-Induced Lymphopenia through Pretreatment Autologous Lymphocyte Infusion (5R21CA240881-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10017926. Licensed CC0.

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