Immune reconstitution in children following chemotherapy for haematological malignancies: a long‐term follow‐up

Abstract

SummaryModern intensive chemotherapy for childhood haematological malignancies has led to high cure rates, but has detrimental effects on the immune system. There is little knowledge concerning long-term recovery of the adaptive immune system. Here we studied the long-term reconstitution of the adaptive immune system in 31 children treated for haematological malignancies between July 2000 and October 2006. We performed detailed phenotypical and functional analyses of the various B and T cell subpopulations until 5 years after chemotherapy. We show that recovery of newly-developed transitional B cells and naive B and T cells occurred rapidly, within months, whereas recovery of the different memory B and T cell subpopulations was slower and incomplete, even after 5 years postchemotherapy. The speed of B and T cell recovery was age-independent, despite a significant contribution of the thymus to T cell recovery. Plasmablast B cell levels remained above normal and immunoglobulin levels normalised within 1 week. Functional T cell responses were normal, even within the first year post-chemotherapy. This study shows that after intensive chemotherapy for haematological malignancies in children, numbers of several memory B and T cell subpopulations were decreased on the long term, while functional T cell responses were not compromised.

Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression

“…A preliminary case series study also indicates that PF has the potential to ameliorate several side effects caused by chemotherapy in humans (Safdie et al, 2009). One of the side effects, myelosuppression, is often dose-limiting in chemotherapy treatment, in part because damage to adult stem/progenitor cells impairs tissue repair and regeneration (Kofman et al, 2012; Mackall et al, 1994; van Tilburg et al, 2011; Williams et al, 2004). Despite the rising interest in nutrient-dependent changes in stem cell populations, little is known about how acute or periodic dietary interventions affect the hematopoietic system.…”

Immunological Reconstitution in Children After Completing Conventional Chemotherapy of Acute Lymphoblastic Leukemia is Marked by Impaired B‐cell Compartment

“…There are reports of reduction in naïve T cells, while the memory compartment survives relatively well resulting in only mild defect in overall number of T cells. [1][2][3][4] The data on B-cell recovery are sparse. Previous studies have shown considerable B-cell decline both in bone marrow and peripheral blood followed by rapid recovery after cessation of chemotherapy.…”

Guidelines on Vaccinations in Paediatric Haematology and Oncology Patients

“…Most authors agree that the interval time of 6–12 months is adequate to achieve a sufficient immune recovery that, in turn, has a key role in determining the response to vaccination [14, 20, 83, 85–88, 91, 95, 96], but some studies have shown good results after reimmunization with inactivated vaccines already at 3 months [87]. …”