| Immune function in children under chemotherapy for standard risk acute lymphoblastic leukaemia - a prospective study of 20 paediatric patients. | |
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MedLine Citation:
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PMID: 19694715 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Multidrug chemotherapy is a highly effective treatment for paediatric acute lymphoblastic leukaemia (ALL), but at the same time compromises immunity of patients. Immune function in a homogenous cohort of 20 children with standard- and intermediate-risk ALL was analysed by immunophenotyping, intracellular cytokine staining, assessment of serum cytokine concentrations, T-cell receptor (TCR) repertoire diversity and thymic function. B-cells were most severely affected by chemotherapy, rapidly declined under induction and did not recover until the cessation of maintenance therapy. This recovery was paralleled by a relative increase in naive IgM(+)IgD(+)CD27(-) B-cells, indicating de novo B-cell generation as the major pathway for B-cell reconstitution. T- and Natural Killer-cells were less severely affected. Although numerically diminished by chemotherapy, they had partially recovered at the end of induction. Interestingly, CD4:CD8 ratio, distribution of naive versus memory T-cells, cytokine production, TCR-repertoire complexity and thymic function were all only marginally affected by chemotherapy. Patients receiving dexamethasone had significantly less IFNgamma(+) T-cells than those receiving prednisone. Our data show that during chemotherapy in standard- and intermediate-risk paediatric ALL patients the T-cell system remains relatively well preserved. Future studies will show if this effect can be exploited for inclusion of immunotherapy in standard ALL treatment protocols. |
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Authors:
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Matthias Eyrich; Verena Wiegering; Annick Lim; Andre Schrauder; Beate Winkler; Paul G Schlegel |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2009-08-19 |
Journal Detail:
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Title: British journal of haematology Volume: 147 ISSN: 1365-2141 ISO Abbreviation: Br. J. Haematol. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-16 Completed Date: 2010-02-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372544 Medline TA: Br J Haematol Country: England |
Other Details:
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Languages: eng Pagination: 360-70 Citation Subset: IM |
Affiliation:
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Department of Paediatric Haematology/Oncology and Stem Cell Transplantation, Children's Hospital, University of W?rzburg, W?rzburg, Germany. eyrich_m@klinik.uni-wuerzburg.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Antineoplastic Combined Chemotherapy Protocols / therapeutic use* B-Lymphocyte Subsets / drug effects, immunology Child Child, Preschool Cytokines / biosynthesis, blood Female Genetic Variation Humans Immunity, Cellular / drug effects Immunophenotyping Killer Cells, Natural / drug effects, immunology Lymphocyte Count Male Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*, immunology* Prospective Studies Receptors, Antigen, T-Cell / genetics T-Lymphocyte Subsets / drug effects, immunology Thymus Gland / immunology |
| Chemical | |
Reg. No./Substance:
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0/Cytokines; 0/Receptors, Antigen, T-Cell |
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