减少与强化化疗治疗儿童急性淋巴细胞白血病：对淋巴细胞区室组成的影响。

Reduced versus intensive chemotherapy for childhood acute lymphoblastic leukemia: impact on lymphocyte compartment composition.

机构信息

Department of Pediatric Hematology/Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Leuk Res. 2011 Apr;35(4):484-91. doi: 10.1016/j.leukres.2010.10.005. Epub 2010 Nov 3.

DOI:10.1016/j.leukres.2010.10.005

Abstract

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.

摘要

儿童急性淋巴细胞白血病的化疗可能会导致严重的免疫损伤。在 2006 年至 2009 年间，研究了 140 名患者在接受新型强烈减少（标准风险 (SR)，n=43）和强化化疗方案（中危 (MR)，n=97）期间和之后的淋巴细胞室。过渡性和幼稚 B 细胞以及 IgG(+) / A(+)、IgM(+) 和仅 IgM 记忆 B 细胞在化疗期间显著减少；MR 组中减少更为显著。治疗 1 年后，CD27(+)IgG(+) / A(+)、IgM(+) 和仅 IgM 记忆 B 细胞尚未完全恢复，但这并不仅限于 MR 组。T 细胞室在化疗期间也受到一定影响，但恢复到正常水平。在 MR 组中，NK 细胞在治疗 1 年后尚未完全恢复到正常水平。因此，强化化疗方案会导致严重的、主要是 B 细胞记忆损伤，即使在治疗 1 年后仍持续存在。