Reduced versus intensive chemotherapy for childhood acute lymphoblastic leukemia: impact on lymphocyte compartment composition.
Chemotherapy for childhood acute lymphoblastic leukemia may cause severe immune damage. The lymphocyte compartment of 140 patients during and after a new strongly reduced (standard risk (SR), n=43) and intensive chemotherapy regimen (medium risk (MR), n=97) was studied between 2006 and 2009. Transitional and naive B cells and IgG(+)/A(+), IgM(+) and IgM only memory B cells were significantly reduced during chemotherapy; significantly more in MR group. One year after treatment CD27(+)IgG(+)/A(+), IgM(+) and IgM only memory B cells had still not fully recovered, but this was not confined to the MR group. The T cell compartment was less but also significantly affected during chemotherapy and recovered to normal levels. In the MR group, NK cells had not fully recovered to normal levels 1 year after treatment. Thus, intensive chemotherapy regimens cause severe, mainly B cell memory damage that persists even 1 year after treatment.
Department of Pediatric Hematology/Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. c.m.vantilburg@umcutrecht.nl
Cornelis M
CM
van Tilburg
Vincent H J
VH
van der Velden
Elisabeth A M
EA
Sanders
Tom F W
TF
Wolfs
Jacobus F
JF
Gaiser
Valerie
V
de Haas
Rob
R
Pieters
Andries C
AC
Bloem
Marc B
MB
Bierings
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007156:Immunologic Memory / Q000187:drug effects / Q000276:immunology; D007223:Infant; D007694:Killer Cells, Natural / Q000187:drug effects / Q000276:immunology; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000276:immunology*; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000276:immunology
D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7