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

J 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.

Basic information

Original name

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

Authors

HLAVÁČKOVÁ, Eva (203 Czech Republic, guarantor, belonging to the institution), Zdenka KŘENOVÁ (203 Czech Republic, belonging to the institution), Arpád KEREKES (703 Slovakia, belonging to the institution), Peter SLANINA (703 Slovakia, belonging to the institution) and Marcela VLKOVÁ (203 Czech Republic, belonging to the institution)

Edition

Biomedical Papers, Olomouc: Palacky University, Olomouc, Palacky University, 2024, 1213-8118

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 0.900 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.5507/bp.2023.021

UT WoS

000996390100001

Keywords in English

rituximab; B non-Hodgkin lymphoma; chemotherapy; late complications of chemotherapy; hypogammaglobulinemia; children and adolescents

Abstract

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.

Links

MUNI/A/1098/2022, interní kód MU

Name: Nespecifická imunita u chorob imunitního systému

Investor: Masaryk University, Non-specific immunity in immune system diseases

MUNI/A/1244/2021, interní kód MU

Name: Vrozená imunita a její abnormality v rozvoji imunopatologických stavů

Investor: Masaryk University

MUNI/A/1395/2022, interní kód MU

Name: Personalizovaná léčba v dětské onkologii: multimodální theranostický přístup a „N-of-1 clinical trials“

Investor: Masaryk University

Citovat

HLAVÁČKOVÁ, Eva, Zdenka KŘENOVÁ, Arpád KEREKES, Peter SLANINA and Marcela VLKOVÁ. 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. Biomedical Papers, Olomouc: Palacky University. Olomouc: Palacky University, 2024, vol. 168, No 2, p. 167-176. ISSN 1213-8118. Available from: https://dx.doi.org/10.5507/bp.2023.021.

@article{2291628,
   author = {Hlaváčková, Eva and Křenová, Zdenka and Kerekes, Arpád and Slanina, Peter and Vlková, Marcela},
   article_location = {Olomouc},
   article_number = {2},
   doi = {http://dx.doi.org/10.5507/bp.2023.021},
   keywords = {rituximab; B non-Hodgkin lymphoma; chemotherapy; late complications of chemotherapy; hypogammaglobulinemia; children and adolescents},
   language = {eng},
   issn = {1213-8118},
   journal = {Biomedical Papers, Olomouc: Palacky University},
   title = {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},
   url = {https://biomed.papers.upol.cz/corproof.php?tartkey=bio-000000-3334},
   volume = {168},
   year = {2024}
}

TY  - JOUR
ID  - 2291628
AU  - Hlaváčková, Eva - Křenová, Zdenka - Kerekes, Arpád - Slanina, Peter - Vlková, Marcela
PY  - 2024
TI  - 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
JF  - Biomedical Papers, Olomouc: Palacky University
VL  - 168
IS  - 2
SP  - 167-176
EP  - 167-176
PB  - Palacky University
SN  - 12138118
KW  - rituximab
KW  - B non-Hodgkin lymphoma
KW  - chemotherapy
KW  - late complications of chemotherapy
KW  - hypogammaglobulinemia
KW  - children and adolescents
UR  - https://biomed.papers.upol.cz/corproof.php?tartkey=bio-000000-3334
N2  - 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.
ER  -

HLAVÁČKOVÁ, Eva, Zdenka KŘENOVÁ, Arpád KEREKES, Peter SLANINA and Marcela VLKOVÁ. 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. \textit{Biomedical Papers, Olomouc: Palacky University}. Olomouc: Palacky University, 2024, vol.~168, No~2, p.~167-176. ISSN~1213-8118. Available from: https://dx.doi.org/10.5507/bp.2023.021.

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