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

Article in a journal

Field of Study

30204 Oncology

Country of publisher

Czech Republic

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 0.700 in 2023

RIV identification code

RIV/00216224:14110/24:00135139

Organization unit

Faculty of Medicine

DOI

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

UT WoS

000996390100001

EID Scopus

2-s2.0-85194183702

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

Cite

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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