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- Title
Defects in lymphocyte subsets and serological memory persist a median of 10 years after high-dose therapy and autologous progenitor cell rescue for malignant lymphoma.
- Authors
Dean, H F; Cazaly, A; Hurlock, C; Borras, J; Williams, A P; Johnson, P W; Davies, A J
- Abstract
The number of survivors having undergone high-dose therapy (HDT) followed by auto-SCT continues to increase, although some of the long-term sequelae remain incompletely understood. The immunological status and quality of life of 37 HDT/auto-SCT survivors with lymphoma in continuous remission of 3 years were assessed alongside 14 age-matched controls. At a median follow-up of 10.5 years (range 2.2-20.2) following HDT/auto-SCT, the proportion of CD4+ cells remained significantly reduced in patients compared with controls (median 43.4% vs 62.5%, respectively; P=<0.001), predominantly a result of sustained reduction in the naive CD4+ component (P<0.001). Naive CD8+ lymphocytes (P=0.014) and transitional B cells (P=0.008) were also significantly reduced, but differences in other lymphocyte subsets were not observed. Uptake of revaccination following HDT/auto-SCT was sporadic; between 11% and 33% of patients had serological titres outside the protective ranges for five of six routinely used vaccines. In the main, patients were found to have a good quality of life, although their EORTC QLQ-C30 questionnaire scores were significantly lower for the physical and social functioning domains compared with controls. Ten years after HDT/auto-SCT immunological deficits persist; to avoid excess risk of preventable disease, serological immunity should be assessed post HDT/auto-SCT followed by appropriate revaccination.
- Subjects
LYMPHOCYTES; LYMPHOMA treatment; PROGENITOR cells; STEM cell transplantation; IMMUNE reconstitution inflammatory syndrome; QUALITY of life; SEROLOGY
- Publication
Bone Marrow Transplantation, 2012, Vol 47, Issue 12, p1545
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2012.73