Severe, persistent, and fatal T-cell immunodeficiency following therapy for infantile leukemia

Pediatr Blood Cancer. 2016 Nov;63(11):2046-9. doi: 10.1002/pbc.26108. Epub 2016 Jun 29.

Abstract

We describe five cases of children who completed chemotherapy for infantile acute lymphoblastic leukemia (ALL) and soon after were diagnosed with severe T-cell, non-HIV immunodeficiency, with varying B-cell and NK-cell depletion. There was near absence of CD3(+) , CD4(+) , and CD8(+) cells. All patients developed multiple, primarily opportunistic infections. Unfortunately, four patients died, although one was successfully treated by hematopoietic stem cell transplantation. These immunodeficiencies appeared to be secondary to intensive infant ALL chemotherapy. Our report highlights the importance of the early consideration of this life-threatening immune complication in patients who received chemotherapy for infantile ALL.

Keywords: ALL; death; immunocompromised host; immunodeficiency; infant leukemia; molecular diagnosis and therapy.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Child, Preschool
  • Fatal Outcome
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunologic Deficiency Syndromes / etiology*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • T-Lymphocytes / immunology*