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Critical Reviews™ in Immunology
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Critical Reviews™ in Immunology

DOI: 10.1615/CritRevImmunol.2017018916
pages 315-327

Acquired T-Cell Immunodeficiency in Thymoma Patients

Petros Christopoulos
Department of Thoracic Oncology, Thoraxklinik at the Heidelberg University Medical Center, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Rontgenstr. 1, 69126 Heidelberg, Germany
Paul Fisch
Department of Pathology, University Medical Center Freiburg, Breisacher Str. 115a, 79106 Freiburg, Germany


Acquired T-cell immunodeficiency can occur in thymoma patients with or without hypogammaglobulinemia (Good's syndrome), but it has received little attention to date. It appears predominantly associated with lymphocyte-rich (i.e., cortical or mixed) thymomas and frequently coexists with autoimmune manifestations. The main abnormalities are an increase in circulating naive T cells, cutaneous T-cell anergy, TCR hyporesponsiveness in vitro as well as a numerical and functional impairment of regulatory T cells. All of these probably result from an abnormal T-cell maturation in the neoplastic thymic microenvironment. A better understanding of thymoma-related acquired T-cell immunodeficiency will be important for immunotherapy of this orphan disease as well as for the prevention and treatment of opportunistic infections, autoimmune complications and secondary malignancies that contribute to the morbidity and mortality of thymoma patients.

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