Assessment of Humoral Immune Recovery in Children with Hematological malignancies after Completion of Chemotherapy

Background: Childhood cancer is relatively rare, the most common types include, leukemias, brain cancers, and lymphomas. Children with cancer usually suffered from immunosuppression due to either the disease itself or its treatment. In this study, we aimed to assess the humoral immunity after completion of the treatment plan in children with hematological malignancies. Patients and methods: Twenty-nine patients were evaluated in a prospective study conducted between March 2018 and April 2020 at the Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University. The patients were assessed for the concentration of total serum IgM, IgG, and specific measles IgM and IgG within one month after completing treatment, at 3 and 6months post-treatment, respectively. Results:
The mean age of the patients was 6.36 ± 4.09 years, and 55.2 % were males. Patients with acute lymphoblastic leukemia (ALL) constituted 58.6% of the studied patients. Most patients (62.1%) were stratified as intermediate risk. Compared to normal reference values of immunoglobulins, our patients had significantly low levels of total IgM and total IgG at finishing chemotherapy (P <0.001), while at three and six months only total IgG continued to be significantly low (P=<0.001). As regard specific measles immunoglobulins (Igs), measles IgM was borderline higher (P=0.059) while measles IgG showed higher values compared to reference values (P=˂0.001) at finishing treatment, both specific measles immunoglobulins increased significantly to levels higher than normal reference values at three and six months after finishing(P=˂0.001). Less intensive treatment and duration of treatment had significantly affected the level of specific measles IgG (P=0.012, P=Patients with hematological malignancies are vulnerable to humoral immune suppression at the end of the treatment, which persists for up to six months after stopping treatment. A shorter duration of treatment was the main factor that affected the immune recovery of our patients.