Immune reconstitution in children following chemotherapy for acute leukemia.

Autor: Williams AP; Faculty of Medicine and Institute for Life Sciences University of Southampton Southampton UK., Bate J; NIHR Southampton Clinical Research Facility NIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine Centre University Hospital Southampton NHS Foundation Trust Southampton UK., Brooks R; Faculty of Medicine and Institute for Life Sciences University of Southampton Southampton UK., Chisholm J; Department of Paediatric Oncology Royal Marsden Hospital Sutton Surrey., Clarke SC; Faculty of Medicine and Institute for Life Sciences University of Southampton Southampton UK., Dixon E; Southampton Clinical Trials Unit Southampton UK., Faust SN; Faculty of Medicine and Institute for Life Sciences University of Southampton Southampton UK., Galanopoulou A; Southampton Clinical Trials Unit Southampton UK., Heath PT; Paediatric Infectious Diseases Research Group & Vaccine Institute St. George's University of London and St. Georges University Hospitals NHS Trust London UK., Maishman T; Southampton Clinical Trials Unit Southampton UK., Mapstone S; NIHR Southampton Clinical Research Facility NIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine Centre University Hospital Southampton NHS Foundation Trust Southampton UK., Patel SR; Paediatric Department Croydon University Hospital Croydon UK., Vora A; Department of Paediatric Haematology Great Ormond Street Hospital London UK., Wilding SA; Southampton Clinical Trials Unit Southampton UK., Gray JC; Faculty of Medicine and Institute for Life Sciences University of Southampton Southampton UK.; NIHR Southampton Clinical Research Facility NIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine Centre University Hospital Southampton NHS Foundation Trust Southampton UK.
Jazyk: angličtina
Zdroj: EJHaem [EJHaem] 2020 Jun 10; Vol. 1 (1), pp. 142-151. Date of Electronic Publication: 2020 Jun 10 (Print Publication: 2020).
DOI: 10.1002/jha2.27
Abstrakt: Although survival rates for pediatric acute lymphoblastic leukemia are now excellent, this is at the expense of prolonged chemotherapy regimens. We report the long-term immune effects in children treated according to the UK Medical Research Council UKALL 2003 protocol. Peripheral blood lymphocyte subsets and immunoglobulin levels were studied in 116 participants, at six time points, during and for 18-month following treatment, with 30-39 patients analyzed at each time point. Total lymphocytes were reduced during maintenance chemotherapy and remained low 18 months following treatment completion. CD4 T cells remained significantly reduced 18 months after treatment, but CD8 cells and natural killer cells recovered to normal values. The fall in naïve B-cell numbers during maintenance was most marked, but numbers recovered rapidly after cessation of treatment. Memory B cells, particularly nonclass-switched memory B cells, remained below normal levels 18 months following treatment. All immunoglobulin subclasses were reduced during treatment compared to normal values, with IgM levels most affected. This study demonstrates that immune reconstitution differs between lymphocyte compartments. Although total B-cell numbers recover rapidly, disruption of memory/naïve balance persists and T-cell compartment persist at 18 months. This highlights the impact of modern chemotherapy regimens on immunity, and thus, infectious susceptibility and response to immunization.
(© 2020 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: