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Severe, persistent, and fatal T-cell immunodeficiency following therapy for infantile leukemia

Ashley V Geerlinks1, Thomas Issekutz2, Justin T Wahlstrom3

  • 1Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS, Canada. Ashley.geerlinks@iwk.nshealth.ca.

Pediatric Blood & Cancer
|June 30, 2016
PubMed

Insights

Infants completing chemotherapy for acute lymphoblastic leukemia (ALL) can develop severe T-cell immunodeficiency. This serious complication requires early consideration in ALL survivors to prevent opportunistic infections and mortality.

Area of Science:

  • Pediatric Oncology
  • Immunology
  • Hematology

Background:

  • Infantile acute lymphoblastic leukemia (ALL) requires intensive chemotherapy regimens.
  • Post-chemotherapy immune recovery can be complex in pediatric patients.

Observation:

  • Five children diagnosed with severe T-cell immunodeficiency post-chemotherapy for infantile ALL.
  • Observed near absence of CD3(+), CD4(+), and CD8(+) T-cells.
  • Patients exhibited varying B-cell and NK-cell depletion.

Findings:

  • All affected children developed multiple opportunistic infections.
  • Four out of five patients succumbed to the condition.
  • One patient achieved successful recovery through hematopoietic stem cell transplantation.

Implications:

  • Chemotherapy for infantile ALL can precipitate life-threatening secondary immunodeficiencies.
  • Early recognition and management of T-cell depletion are crucial for ALL survivors.
  • Hematopoietic stem cell transplantation offers a potential treatment avenue for severe cases.

Keywords:
ALLdeathimmunocompromised hostimmunodeficiencyinfant leukemiamolecular diagnosis and therapy

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