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.

Keywords::

• Acute lymphoblastic leukemia
• immune reconstitution
• B-lymphocyte subsets
• T-lymphocyte subsets
• pediatric patients

Acknowledgements

We would like to thank the Parent's Initiative Group for Children with Leukemia- and Solid Tumors Würzburg e.V. as well as the Tour of Hope Foundation for their continued support and an unrestricted research grant.

Potential conflict of interest:

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

This project was supported by a training grant from the IZKF post-doctoral qualification program of the University of Würzburg (granted to V.W.) and a training grant from the Deutsche Forschungsgesellschaft (granted to H.M.).