Chemotherapy for childhood acute lymphoblastic leukemia may cause severe immune damage. The lymphocyte compartment of 140 patients during and after a new strongly reduced (standard risk (SR), n = 43) and intensive chemotherapy regimen (medium risk (MR), n = 97) was studied between 2006 and 2009. Transitional and naive B cells and IgG+/A+, IgM+ and IgM only memory B cells were significantly reduced during chemotherapy; significantly more in MR group. One year after treatment CD27+IgG+/A+, IgM+ and IgM only memory B cells had still not fully recovered, but this was not confined to the MR group. The T cell compartment was less but also significantly affected during chemotherapy and recovered to normal levels. In the MR group, NK cells had not fully recovered to normal levels 1 year after treatment. Thus, intensive chemotherapy regimens cause severe, mainly B cell memory damage that persists even 1 year after treatment.

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Leukemia Research: clinical and laboratory studies
Erasmus MC: University Medical Center Rotterdam

Tilburg, C., van der Velden, V., Sanders, E., Wolfs, T., Gaiser, J., de Haas, V., … Bierings, M. (2011). Reduced versus intensive chemotherapy for childhood acute lymphoblastic leukemia: Impact on lymphocyte compartment composition. Leukemia Research: clinical and laboratory studies, 35(4), 484–491. doi:10.1016/j.leukres.2010.10.005