Immune function in children under chemotherapy for standard risk acute lymphoblastic leukaemia - a prospective study of 20 paediatric patients

Eyrich, M., Wiegering, V., Lim, A., Schrauder, A., Winkler, B. and Schlegel, P. G. (2009) Immune function in children under chemotherapy for standard risk acute lymphoblastic leukaemia - a prospective study of 20 paediatric patients British Journal of Haematology, 147 (3). pp. 360-370. DOI 10.1111/j.1365-2141.2009.07862.x.

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Abstract

P>Multidrug chemotherapy is a highly effective treatment for paediatric acute lymphoblastic leukaemia (ALL), but at the same time compromises immunity of patients. Immune function in a homogenous cohort of 20 children with standard- and intermediate-risk ALL was analysed by immunophenotyping, intracellular cytokine staining, assessment of serum cytokine concentrations, T-cell receptor (TCR) repertoire diversity and thymic function. B-cells were most severely affected by chemotherapy, rapidly declined under induction and did not recover until the cessation of maintenance therapy. This recovery was paralleled by a relative increase in naive IgM+IgD+CD27- B-cells, indicating de novo B-cell generation as the major pathway for B-cell reconstitution. T- and Natural Killer-cells were less severely affected. Although numerically diminished by chemotherapy, they had partially recovered at the end of induction. Interestingly, CD4:CD8 ratio, distribution of naive versus memory T-cells, cytokine production, TCR-repertoire complexity and thymic function were all only marginally affected by chemotherapy. Patients receiving dexamethasone had significantly less IFN gamma+ T-cells than those receiving prednisone. Our data show that during chemotherapy in standard- and intermediate-risk paediatric ALL patients the T-cell system remains relatively well preserved. Future studies will show if this effect can be exploited for inclusion of immunotherapy in standard ALL treatment protocols.

Document Type: Article
Keywords: paediatric leukaemia chemotherapy T cells cytokine production natural-killer-cells t-cell intensive chemotherapy maintenance therapy thymic output childhood recovery expression remission memory
Research affiliation: Kiel University
Refereed: No
DOI etc.: 10.1111/j.1365-2141.2009.07862.x
ISSN: 0007-1048
Date Deposited: 22 Dec 2011 05:20
Last Modified: 08 Oct 2012 10:09
URI: http://eprints.uni-kiel.de/id/eprint/15770

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