Deficits in the IgG memory B-cell recovery after anthracycline treatment is confined to the spleen of rhesus macaques.

Objectives: Loss of vaccine-induced antibodies (Abs) after chemotherapy against paediatric acute lymphoblastic leukaemia (ALL) is common and often necessitates re-immunisation after cessation of treatment. Even so, some ALL survivors fail to mount or to maintain protective Abs. Germinal centres (GCs) are clusters of proliferating B cells in follicles of secondary lymphoid tissues (SLTs) formed during adaptive immune responses and the origins of long-lived memory B and plasma cells that are the source of Abs. Furthermore, productive GC reactions depend on T follicular helper (T) cells. To understand why chemotherapy induces deficits in Ab responses, we examined how SLTs were affected by chemotherapy.

Methods: Rhesus macaques were infused with either three cycles of the anthracycline doxorubicin or saline, followed by immunisation with a and booster antigen. Spleen and lymph nodes were removed, and memory B, bulk T and T cells were examined.

Results: Despite adequate GC morphology, a diminished memory and IgG B-cell population along with diminished total and booster vaccine-specific IgG-producing memory B cells were noted in the spleens of macaques with past doxorubicin exposure compared to the saline-treated controls ( < 0.05). Intact bulk T and T cells were found in the SLTs of treated macaques, which displayed higher CD40L upregulation capacity by their splenic CXCR5 helper T cells ( < 0.01). In contrast to the spleen, the immune cell populations studied were comparable between the lymph nodes of both saline- and doxorubicin-treated macaques.

Conclusion: Our findings suggest that the splenic memory B-cell subset, compared to its lymph node counterpart, is more severely altered by anthracycline treatment.