Effects of a single dose of anti–programmed death-1 monoclonal antibody (MDX-1106; 10 mg/kg) on circulating lymphocyte numbers. (A) Twenty-four hours postdose, a decline in total lymphocyte as well as CD3, CD4, and CD8 numbers was observed (two-sided P = .004, .002, < .001, and .01 respectively; Wilcoxon signed rank test). These parameters followed similar trends, rebounding from days 2 through 29 (two-sided P < .001; two-sided P = .01 for CD8), and declining again from days 29 through 85 (two-sided P < .001; mixed model test for trend with knots [changes in slopes] and repeated measures). Means ± standard error of mean are shown; numbers of patients studied at each time point are indicated in parentheses. (B) Paired analysis of total lymphocyte numbers in 16 patients, comparing immediate pretreatment samples (day 1) with 24-hour post-treatment samples (day 2). A significant decline at day 2 was observed (two-sided P = .004; Wilcoxon signed rank test). Dotted line indicates the lower limit of normal lymphocyte counts.