KEY TAKEAWAYS
- The study aimed to investigate how chemotherapy affects the immune systems of children with ALL and how their immune systems recover.
- Researchers found children with ALL have severe immune compromise after chemotherapy, especially in B cells, affecting prognosis.
Acute lymphoblastic leukemia (ALL) is a type of cancer that affects the bone marrow and blood. Chemotherapy is a common treatment for ALL, but it can have significant side effects, including suppressing the immune system. Understanding how chemotherapy affects the immune systems of children with ALL and how their immune systems recover after treatment is crucial for improving patient outcomes.
Yuting Xu and the team aimed to investigate the influence of chemotherapy on the immune status of individual patients diagnosed with ALL and to elucidate the clinical characteristics of immune reconstitution in patients with ALL following chemotherapy.
Clinical data from children diagnosed with ALL were collected, including data on the number of lymphocyte subsets before chemotherapy, at the end of chemotherapy, 6 months after chemotherapy ended, and 1 year after treatment ended.
About 146 children with ALL participated in the study. Before treatment, T cells, B cells, and NK cells were all reduced to varying degrees. The group with abnormal CD3+ T cell counts experienced significantly higher mortality (21.9% vs. 6.1%) and recurrence rates (31.3% vs. 11.4%) compared to the group with normal CD3+ T cell counts (P< 0.05).
At the end of therapy, T cells, B cells, and NK cells were all significantly compromised compared to the start of chemotherapy, with B cells being the most severely affected (P< 0.001), 6 months after chemotherapy, all indicators, except the CD4/CD8 ratio (P= 0.451), recovered (P< 0.001).
The immune systems of patients with ALL were significantly weakened after chemotherapy, especially B cells. Although B cells mostly returned to normal levels 6 months later, T cells did not. The study suggested that reduced CD3+ T cell numbers may weaken the anti-tumor response, potentially leading to poorer outcomes.
This work was partially supported by the CCCG-ALL-2015 study (research project no. WHTJ-2015043).
Source: https://pubmed.ncbi.nlm.nih.gov/39215273/
Xu Y, Zhang A, Liu A, Hu Q. (2024). “Clinical analysis of immune reconstitution after chemotherapy in children with acute lymphoblastic leukemia.” BMC Pediatr. 2024;24(1):557. Published 2024 Aug 30. doi:10.1186/s12887-024-05030-4
