Τίτλος:
Longitudinal assessment of immunological status and rate of immune recovery following treatment in children with ALL
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background. We prospectively evaluated the immunological status, immune recovery and risk of infection in pediatric ALL patients treated on the BFM 95 protocol. Procedure. Humoral and cellular immunity were evaluated in 72 children with ALL at the end of intensive therapy and values were compared to those at the completion of therapy and 6-monthly. Parameters investigated included lymphocyte subpopulation by flow cytometry, immunoglobulin levels by nephelometry, antibody titers to previous immunizations and delayed hypersensitivity with skin testing. Immune responses were correlated to duration of therapy, CNS radiotherapy, age and sex. Results. Humoral immunity was severely depressed by the end of intensive therapy with low immunoglobulin levels and CD19, improved after therapy cessation. Cellular immune responses were normal at the end of intensive treatment but declined significantly by the end of therapy and both CD4 and CD8 remained low at later evaluation points whereas CD4/CD8 ratio was increasing. Duration of therapy and CNS radiotherapy did not affect the rate of immune recovery whereas female had higher CD19, CD45RO, and IgM and children >7 years had higher CD19 and lower CD16 and CD3DR. Among immunized children, 86.7% maintained protective antibodies to MMR and 63% to polio. Despite impairment of immunity, infections outside the neutropenic periods were common viral illnesses. Conclusion. Humoral immunity was depressed in children with ALL at the end of intensive therapy but began to recover after cessation of therapy. In contrast, cellular immunity declined significantly by the end of therapy and remained abnormal for at least 1 year post-therapy. © 2007 Wiley-Liss, Inc.
Συγγραφείς:
Kosmidis, S.
Baka, M.
Bouhoutsou, D.
Doganis, D.
Kallergi, C.
Douladiris, N.
Pourtsidis, A.
Varvoutsi, M.
Saxoni-Papageorgiou, F.
Vasilatou-Kosmidis, H.
Περιοδικό:
Pediatric Blood and Cancer
Λέξεις-κλειδιά:
CD16 antigen; CD19 antibody; CD3 antigen; CD4 antigen; CD45RO antigen; CD8 antigen; immunoglobulin; immunoglobulin M; measles antibody; measles mumps rubella vaccine; rubella antibody; virus antibody, acute lymphoblastic leukemia; adolescent; antibody titer; article; CD4 CD8 ratio; cellular immunity; childhood leukemia; clinical protocol; controlled study; correlation analysis; delayed hypersensitivity; female; flow cytometry; human; humoral immunity; immune reconstitution inflammatory syndrome; immune response; immune status; immunization; immunoglobulin blood level; infection risk; intensive care; longitudinal study; lymphocyte subpopulation; major clinical study; male; nephelometry; neutropenia; outcome assessment; preschool child; priority journal; prophylaxis; prospective study; school child; skin test; skull irradiation; treatment duration; treatment response, Adolescent; Agammaglobulinemia; Antibodies, Viral; Antibody Formation; Antigens, CD; Antineoplastic Combined Chemotherapy Protocols; Child; Child, Preschool; Combined Modality Therapy; Cranial Irradiation; Disease Susceptibility; Female; Humans; Immunity, Cellular; Immunocompromised Host; Infant; Infection; Leukemia-Lymphoma, Adult T-Cell; Male; Neutropenia; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Prospective Studies; Skin Tests; T-Lymphocyte Subsets
