本回顾性研究的目的是探讨化疗对急性淋巴细胞白血病（ALL）个体患者免疫状态的影响，阐明化疗后ALL患者免疫重建的临床特征。收集的信息包括化疗前、治疗结束时、治疗结束后六个月和一年后的淋巴细胞亚群数量信息。总共包括 146 名 ALL 儿童，T 细胞、B 细胞、 NK细胞在治疗前均有不同程度的减少。 CD3  T细胞数量异常组的死亡率（21.9% vs. 6.1%）和复发率（31.3% vs. 11.4%）显着高于正常组（P < 0.05）。与化疗开始时相比，治疗结束时T细胞、B细胞和NK细胞均显着受损，其中B细胞受损更严重（P<0.001）。治疗结束时，低危（LR）组B细胞、CD4  T细胞、CD4/CD8、IgG、IgM水平均显着高于中危（IR）组（P < 0.01），且LR组NK细胞明显低于IR组(P < 0.001)。治疗结束6个月后，除CD4/CD8比值（P = 0.451）外，上述指标均恢复（P < 0.001）。停药后ALL患者的免疫系统严重受损，尤其是B细胞。治疗结束后六个月，B细胞基本恢复到正常水平，而T细胞室却没有。 CD3  T 细胞数量受损可能会导致抗肿瘤反应减弱，从而可能导致预后较差。© 2024。作者。

The aim of this retrospective study was to investigate the influence of chemotherapy on the immune status of individual patients diagnosed with acute lymphoblastic leukemia (ALL) and to elucidate the clinical characteristics of immune reconstitution in ALL patients following chemotherapy.Clinical data of children with ALL were gathered, including information on the number of lymphocyte subsets prior to chemotherapy, at the end of therapy, six months, and one year after the end of the treatment.A total of 146 children with ALL were included, and T cells, B cells, and NK cells all decreased to various degrees prior to treatment. The abnormal CD3 + T cell numbers group experienced a considerably higher mortality (21.9% vs. 6.1%) and recurrence rate (31.3% vs. 11.4%) compared to the normal group (P < 0.05). T cells, B cells, and NK cells were all significantly compromised at the end of therapy compared to the beginning of chemotherapy, with B cells being more severely compromised (P < 0.001). At the end of treatment, levels of B cells, CD4 + T cells, CD4/CD8, IgG and IgM in low risk (LR) group were significantly higher than those in intermediate risk (IR) group (P < 0.01), and levels of NK cells in LR group were evidently lower than those in IR group (P < 0.001). Six months after the end of therapy, all the above indicators recovered (P < 0.001) except CD4/CD8 ratio (P = 0.451).The immune systems of the ALL patients were severely compromised upon therapy withdrawal, particularly the B cells. At six months after the therapy ended, the B cells were basically restored to normal level, while the T-cell compartment was not. The impaired numbers of CD3 + T cell may contribute to a weakened anti-tumor response, potentially leading to a poorer prognosis.© 2024. The Author(s).