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294 Omrani et al.| Journal of Clinical and Translational Research 2024; 10(5): 291-295
addition, Williams et al. revealed that there is no relationship for Children’s Health, Shahid Beheshti University of Medical
between gender and the recovery rate of the immune system Sciences, Tehran, Iran for their kind cooperation.
after chemotherapy cessation [18]. They also reported that the
WBC level did not change significantly with increased time Funding
after treatment cessation. This research did not receive any specific grant from funding
The present study displayed increased levels of WBC, agencies in public, commercial, or not-for-profit sectors.
lymphocytes, and neutrophils 6 months after treatment
cessation. Several studies confirmed this finding [8,18]. Perkins Conflicts of Interest
et al. investigated the immune system status immediately and The authors declare that they have no competing interests.
6 months after treatment cessation in 20 patients with ALL and
acute myeloid leukemia; it was reported that the number of Ethics Approval and Consent to Participate
WBCs decreased at both times, but this decrease is compensated
to some extent after 6 months following treatment cessation [8]. This study was approved by the Ethics Committee of
In a study by Kosmidis et al., it was also reported that children Pediatric Congenital Hematologic Disorders Research Center,
experienced significant neutropenia during the first few months Shahid Beheshti University of Medical Sciences, Tehran, Iran
of treatment, but this is less common during maintenance (IRSBMU.MSP.REC.1399.473). A questionnaire was designed
chemotherapy [19]. However, lymphopenia with low levels of for each child, and written informed consent was acquired from
B and T cells is common and has been reported to persist for up their parents during the course of sample collection.
to 6 months after treatment [14,19]. Consent for Publication
In this study, the average antibody level against diphtheria and
tetanus increased 6 months after treatment, whereas the average We explained the aims of the present study to children and
antibody level against hepatitis B decreased. Although these their parents. A questionnaire was planned for each of the
changes were not significant, the immune system restoration included children and written informed consent was obtained
resulted in increases in WBCs and IgG, IgM, IgE, and IgA from all children and their parents during the study.
in this study and previous studies [18,20], and an increase in Availability of Data
antibody levels against diphtheria and tetanus was also expected.
The decrease in antibodies against hepatitis requires further All data generated or analyzed during this study are included
investigation; it may also return to the average level in a more in this published article.
extended period, as studies have reported that some changes
in immune system reconstruction occur in the long term [19]. References
Collectively, we revealed improvement of the humoral immune [1] Namayandeh SM, Khazaei Z, Najafi ML, Goodarzi E,
system to some extent after 6 months of chemotherapy, but Moslem A. Global Leukemia in Children 0-14 Statistics
similar to Perkins et al., some degree of defects in the immune 2018, Incidence and Mortality and Human Development
system were also reported [8]. Index (HDI): GLOBOCAN Sources and Methods. Asian
One of the limitations of this research is that the sample Pac J Cancer Prev 2020;21:1487.
patient population was small, and a study with a more significant doi: 10.31557/APJCP.2020.21.5.1487
population is warranted. In addition, this study did not separate
the different types of leukemia, and it is recommended that [2] Hunger SP, Mullighan CG. Acute Lymphoblastic
future studies distinguish between these types for a more Leukemia in Children. New Engl J Med
detailed investigation. 2015;373(16):1541-52.
doi: 10.1056/NEJMra1400972
5. Conclusion [3] Steinherz PG, Brown AE, Gross PA, Braun D, Ghavimi F,

The findings of this study indicate that the status of the Wollner N, et al. Influenza Immunization of Children
humoral immune system exhibits slight improvement 6 months with Neoplastic Diseases. Cancer 1980;45:750-6.
after the end of chemotherapy compared to the initial assessment. doi: 10.1002/1097-0142(19800215)45:4<750::aid-
In addition, there is no difference between age and the condition cncr2820450423>3.0.co;2-z
of the humoral immune system in the patients 6 months after [4] Tavakol M, Delavari S, Salami F, Ansari S, Rasouli SE,
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Acknowledgments [5] Griggio V, Perutelli F, Salvetti C, Boccellato E,
Boccadoro M, Vitale C, et al. Immune Dysfunctions
The authors would like to thank the Pediatric Congenital and Immune-based Therapeutic Interventions in
Hematologic Disorders Research Center, Research Institute Chronic Lymphocytic Leukemia. Front Immunol

DOI: http://doi.org/10.36922/jctr.24.00050