title: Impaired B-cell reconstitution in children after chemotherapy for standard or medium risk acute precursor B-lymphoblastic leukemia.
abstract: Chemotherapy for childhood acute lymphoblastic leukemia (ALL) is a highly effective treatment, but at the same time causes significant suppression of the patient's immunity. Immune reconstitution was studied in a homogeneous cohort of 48 children with standard or medium risk ALL treated according to the ALL-Berlin-Frankfurt-Münster (BFM) protocol. Whereas the T-cell compartment was only moderately affected and recovered to normal levels quickly after treatment cessation, B-cells were significantly reduced during and after therapy. In particular, the naive B-cell compartment declined. Even 5 years after the end of therapy, B-cell distribution was disturbed and patients showed an ongoing reconstitution. Thus, even standard regimens for chemotherapy cause severe B-cell depletion that resolves only gradually.
authors.affiliation: Department of Pediatric Haematology, Hemostaseology, Oncology and Stem Cell Transplantation.
authors.forename: Verena
authors.initials: V
authors.lastname: Wiegering
authors.forename: Jana
authors.initials: J
authors.lastname: Frank
authors.forename: Sandra
authors.initials: S
authors.lastname: Freudenberg
authors.forename: Henner
authors.initials: H
authors.lastname: Morbach
authors.forename: Paul G
authors.initials: PG
authors.lastname: Schlegel
authors.forename: Matthias
authors.initials: M
authors.lastname: Eyrich
authors.forename: Beate
authors.initials: B
authors.lastname: Winkler
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001215:Asparaginase / Q000627:therapeutic use; D053264:B-Cell Activating Factor / Q000378:metabolism; D016175:B-Lymphocyte Subsets / Q000276:immunology* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003630:Daunorubicin / Q000627:therapeutic use; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D007694:Killer Cells, Natural / Q000276:immunology / Q000378:metabolism; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000276:immunology* / Q000378:metabolism; D011241:Prednisone / Q000627:therapeutic use; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D053264:B-Cell Activating Factor; D015415:Biomarkers; D014750:Vincristine; D001215:Asparaginase; D011241:Prednisone; D003630:Daunorubicin