Immune function measured following long-term treatment with monotherapy sirolimus in non-ALPS patients. (A) ALC. Although not statistically significant, 5 of the 12 subjects demonstrated an increase in the ALC, 2 with no change, 2 with decreases but remained normal, and 3 subjects whose ALC dropped to a more moderate lymphopenia range (post-sirolimus ALC range, 320 to 3456 μL; P > .999). (B) IgG quantification; it remained in a normal range for most, and were unchanged before and after the use of sirolimus (P = .8438). (C) CD4 and (D) CD8 counts were monitored pre- and post- long-term administration of sirolimus. CD4 and CD8 counts mostly either remained the same or increased (P = .8438 and P = .6250, respectively). Three subjects had a decrease in the CD4 count; however, only 1 fell to a level <200 μL. That same patient also demonstrated a drop in the CD8 count to a low level (from 492 to 96 μL), after 3 months of sirolimus treatment. Also not depicted here, the response to mitogens was available on 3 subjects: 1 remained normal at 1 year, whereas 2 were reduced at 1 and 4 years. Measurements post-sirolimus treatment varied per subject, between 3 months to 4 years of treatment.