Immune reconstitution in children following chemotherapy for haematological malignancies: a long-term follow-up.
Modern intensive chemotherapy for childhood haematological malignancies has led to high cure rates, but has detrimental effects on the immune system. There is little knowledge concerning long-term recovery of the adaptive immune system. Here we studied the long-term reconstitution of the adaptive immune system in 31 children treated for haematological malignancies between July 2000 and October 2006. We performed detailed phenotypical and functional analyses of the various B and T cell subpopulations until 5 years after chemotherapy. We show that recovery of newly-developed transitional B cells and naive B and T cells occurred rapidly, within months, whereas recovery of the different memory B and T cell subpopulations was slower and incomplete, even after 5 years post-chemotherapy. The speed of B and T cell recovery was age-independent, despite a significant contribution of the thymus to T cell recovery. Plasmablast B cell levels remained above normal and immunoglobulin levels normalised within 1 week. Functional T cell responses were normal, even within the first year post-chemotherapy. This study shows that after intensive chemotherapy for haematological malignancies in children, numbers of several memory B and T cell subpopulations were decreased on the long term, while functional T cell responses were not compromised.
Department of Paediatric Haematology/Oncology, University Medical Center Utrecht, The Netherlands. c.m.vantilburg@umcutrecht.nl
Cornelis M
CM
van Tilburg
Rogier
R
van Gent
Marc B
MB
Bierings
Sigrid A
SA
Otto
Elisabeth A M
EA
Sanders
Elisabeth E
EE
Nibbelke
Jacobus F
JF
Gaiser
Pirkko L
PL
Janssens-Korpela
Tom F W
TF
Wolfs
Andries C
AC
Bloem
José A M
JA
Borghans
Kiki
K
Tesselaar
D056704:Adaptive Immunity / Q000187:drug effects*; D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000494:pharmacology*; D016175:B-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology; D049109:Cell Proliferation / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D016130:Immunophenotyping; D008213:Lymphocyte Activation / Q000187:drug effects; D018655:Lymphocyte Count; D008297:Male; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology; D013950:Thymus Gland / Q000187:drug effects / Q000276:immunology
D000970:Antineoplastic Agents; D007136:Immunoglobulins