Pathology & Oncology Research

, 14:391

Late Immune Recovery in Children Treated for Malignant Diseases

  • Gabor T. Kovacs
  • Olga Barany
  • Barbara Schlick
  • Monika Csoka
  • Judit Gado
  • Andrea Ponyi
  • Judit Müller
  • Julia Nemeth
  • Peter Hauser
  • Daniel J. Erdelyi
Original Paper

DOI: 10.1007/s12253-008-9073-5

Cite this article as:
Kovacs, G.T., Barany, O., Schlick, B. et al. Pathol. Oncol. Res. (2008) 14: 391. doi:10.1007/s12253-008-9073-5

Abstract

In this study we analyzed the recovery of the immune system in children after completion of the therapy. We analysed 88 children (51 boys, 37 girls, mean age at diagnosis: 7.8 years) receiving chemotherapy for malignant diseases (43 acute lymphoblastic leukemia, 15 lymphoma, 20 bone tumor, ten other solid tumors). Serum immunoglobulin levels (Ig), natural killer activity (NK), antibody-dependent cellular cytotoxicity (ADCC) and T and B cell proliferation were determined 1 year after cessation of therapy. The mean levels of Ig were in the normal range at a mean of 13 months after chemotherapy (IgG: 11.2 ± 3.3, IgA: 1.6 ± 0.9, IgM: 1.0 ± 0.5 g/l), however in the leukemic patients serum IgG was below the lower limit of the normal range in 3/43 (7.0%) cases, serum IgA was low in 5/43 (11.6%) and serum IgM was decreased in 4/43 (9.3%) cases. In the solid tumor patients IgG values were within the normal range and only 2–2/45 children had lower values for IgA and IgM (4.4%). NK activity decreased in 7/43 (16.3%) leukemic patients, and in 3/45 (6.7%) solid tumor patients, ADCC decreased in 8/43 (18.6%) and 3/45 (6.7%), respectively (p < 0.001). B-cell blastic transformation was decreased in 3/43 (7%) leukemic patients and in 4/45 (8.9%) solid tumor patients. At the same time T-cell blastic transformation was altered in 5/43 (11.6%) and in 4/45 (8.9%) cases, respectively. Leukemic patients had significantly more infections during the first year after chemotherapy than solid tumor patients (1.60 ± 1.18 vs 0.96 ± 1.14; p = 0.011). No significant correlations could be found between the investigated immune parameters and the number and severity of infections. It is concluded, that cytotoxic therapy can lead to long-term depression of the immune system, first of all in leukemic patients.

Keywords

Humoral immunity Cellular immunity Late effects Malignant diseases Children 

Abbreviations

ADCC

antibody-dependent cellular cytotoxicity

ALL

acute lymphoblastic leukemia

AL

acute leukemia

AML

acute myeloblastic leukemia

BFM

Berlin-Frankfurt-Münster Study Group

BMT

bone marrow transplantation

CI

cytotoxicity index

Con-A

concavalin A

DNA

desoxy-ribonucleic acid

HD

Hodgkin’s disease

Ig

immunoglobulin

IL

interleukin

NHL

non-Hodgkin lymphoma

NK

natural killer

OSC

osteosarcoma

PHA

phytohemagglutinin

PWM

pokeweed mitogen

Th

T-helper cell

Copyright information

© Arányi Lajos Foundation 2008

Authors and Affiliations

  • Gabor T. Kovacs
    • 1
  • Olga Barany
    • 1
  • Barbara Schlick
    • 1
  • Monika Csoka
    • 1
  • Judit Gado
    • 1
  • Andrea Ponyi
    • 1
  • Judit Müller
    • 1
  • Julia Nemeth
    • 1
  • Peter Hauser
    • 1
  • Daniel J. Erdelyi
    • 1
  1. 1.Second Department of PediatricsSemmelweis UniversityBudapestHungary