2024
B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center and review of the literature
HLAVÁČKOVÁ, Eva, Zdenka KŘENOVÁ, Arpád KEREKES, Peter SLANINA, Marcela VLKOVÁ et. al.Základní údaje
Originální název
B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center and review of the literature
Autoři
HLAVÁČKOVÁ, Eva (203 Česká republika, garant, domácí), Zdenka KŘENOVÁ (203 Česká republika, domácí), Arpád KEREKES (703 Slovensko, domácí), Peter SLANINA (703 Slovensko, domácí) a Marcela VLKOVÁ (203 Česká republika, domácí)
Vydání
Biomedical Papers, Olomouc: Palacky University, Olomouc, Palacky University, 2024, 1213-8118
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30204 Oncology
Stát vydavatele
Česká republika
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 0.900 v roce 2022
Organizační jednotka
Lékařská fakulta
UT WoS
000996390100001
Klíčová slova anglicky
rituximab; B non-Hodgkin lymphoma; chemotherapy; late complications of chemotherapy; hypogammaglobulinemia; children and adolescents
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 12. 7. 2024 12:48, Mgr. Tereza Miškechová
Anotace
V originále
Background. RTX, an anti-CD20 monoclonal antibody, added to chemotherapy has proven to be effective in children and adolescents with high-grade, high-risk and matured non-Hodgk in lymphoma. RTX leads to prompt CD19+ B lymphocyte depletion. However, despite preserved immunoglobulin production by long-lived plasmablasts after treatment, patients remain at risk of prolonged hypogammaglobulinemia. Further, there are few general guidelines for immunology laboratories and clinical feature monitoring after B cell-targeted therapies. The aim of this paper is to describe B cell reconstitution and immunoglobulin levels after pediatric B-NHL protocols, that included a single RTX dose and to review the literature. Methods. A retrospective single-center study on the impact of a single RTX dose included in a chemotherapeutic pediatric B Non-Hodgkin Lymphoma (B-NHL) treatment protocols. Immunology laboratory and clinical features were evaluated over an eight hundred days follow-up (FU) period, after completing B-NHL treatment. Results. Nineteen patients (fifteen Burkitt lymphoma, three Diffuse large B cell lymphoma, and one Marginal zone B cell lymphoma) fulfilled the inclusion criteria. Initiation of B cell subset reconstitution occurred a median of three months after B-NHL treatment. Naive and transitional B cells declined over the FU in contrast to the marginal zone and the switched memory B cell increase. The percentage of patients with IgG, IgA, and IgM hypogammaglobulinemia declined consistently over the FU. Prolonged IgG hypogammaglobulinemia was detectable in 9%, IgM in 13%, and IgA in 25%. All revaccinated patients responded to protein-based vaccines by specific IgG antibody production increase. Following antibiotic prophylaxes, none of the patients with hypogammaglobulinemia manifested with either a severe or opportunistic infection course. Conclusion. The addition of a single RTX dose to the chemotherapeutic treatment protocols was not shown to increase the risk of developing secondary antibody deficiency in B-NHL pediatric patients. Observed prolonged hypogammaglobulinemia remained clinically silent. However interdisciplinary agreement on regular long-term immunology FU after anti-CD20 agent treatment is required.
Návaznosti
MUNI/A/1098/2022, interní kód MU |
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MUNI/A/1244/2021, interní kód MU |
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MUNI/A/1395/2022, interní kód MU |
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