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.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Asparaginase / therapeutic use
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B-Cell Activating Factor / metabolism
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B-Lymphocyte Subsets / immunology*
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B-Lymphocyte Subsets / metabolism
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Biomarkers / metabolism
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Child
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Child, Preschool
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Daunorubicin / therapeutic use
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Female
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Flow Cytometry
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Follow-Up Studies
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Humans
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Immunophenotyping
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Infant
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Killer Cells, Natural / immunology
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Killer Cells, Natural / metabolism
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Male
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Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
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Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / immunology*
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Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / metabolism
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Prednisone / therapeutic use
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T-Lymphocyte Subsets / immunology
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T-Lymphocyte Subsets / metabolism
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Treatment Outcome
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Vincristine / therapeutic use
Substances
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B-Cell Activating Factor
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Biomarkers
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Vincristine
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Asparaginase
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Prednisone
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Daunorubicin