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Related Experiment Videos

T cell function in children with acute lymphoblastic leukaemia

K A Nash1, G Mohammed, N Nandapalan

  • 1Department of Child Heath, University and Royal Victoria Infirmary, Newcastle upon Tyne.

British Journal of Haematology
|March 1, 1993
PubMed
Summary

Children with acute lymphoblastic leukaemia (ALL) undergoing chemotherapy show impaired T cell function, particularly CD8+ lymphocytes, even after remission. This cellular immunity defect may increase susceptibility to severe viral infections during treatment.

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Area of Science:

  • Immunology
  • Pediatric Oncology
  • Virology

Background:

  • Intensive chemotherapy improves outcomes for childhood acute lymphoblastic leukaemia (ALL).
  • Viral infections, particularly herpesviruses and paramyxoviruses, pose a significant threat during ALL therapy, impacting survival and quality of life.
  • Cellular immunity, especially T cell function, is crucial for controlling these cell-associated infections.

Purpose of the Study:

  • To investigate T cell responsiveness in children undergoing therapy for acute lymphoblastic leukaemia (ALL).
  • To identify potential defects in cellular immunity contributing to viral infection susceptibility in ALL patients.

Main Methods:

  • Assessed in vitro proliferative responses of peripheral blood leucocytes (PBL) to phytohaemagglutinin (PHA) and Herpes simplex virus antigens.

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  • Quantified T cell subsets (CD4+ and CD8+).
  • Measured gamma interferon secretion and cytotoxic T lymphocyte responses to allogeneic cells.

    • Main Results:

    • T cell responses to PHA were impaired in ALL patients before treatment and during remission induction, due to reduced T cell numbers, serum inhibitors, and lymphocyte damage.
    • While PHA responses normalized in remission, gamma interferon secretion was significantly reduced in ALL patients compared to controls.
    • Cytotoxic T lymphocyte responses to allogeneic cells were deficient in most ALL patients in remission.

    Conclusions:

    • Children with ALL exhibit impaired T cell function, including reduced gamma interferon production and cytotoxic T lymphocyte activity, even after achieving remission.
    • These persistent cellular immunity defects may explain the increased risk of severe viral infections during ALL continuation therapy.
    • Further research is needed to understand and address these immune deficits to improve long-term outcomes for pediatric ALL survivors.