Immune function in childhood cancer survivors: a Children's Oncology Group review

Gregory M.T. Guilcher, Linda Rivard, Jennifer T. Huang, Nicola A.M. Wright, Lynette Anderson, Hesham Eissa, Wendy Pelletier, Shanti Ramachandran, Tal Schechter, Ami J. Shah, Ken Wong, Eric J. Chow

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations


Childhood cancer and its treatment often impact the haematopoietic and lymphatic systems, with immunological consequences. Immunological assessments are not routinely included in surveillance guidelines for most survivors of childhood cancer, although a robust body of literature describes immunological outcomes, testing recommendations, and revaccination guidelines after allogeneic haematopoietic cell transplantation. Survivorship care providers might not fully consider the impaired recovery of a child's immune system after cancer treatment if the child has not undergone haematopoietic cell transplantation. We did a scoping review to collate the existing literature describing immune function after childhood cancer therapy, including both standard-dose chemotherapy and high-dose chemotherapy with haematopoietic cell rescue. This Review aims to summarise: the principles of immunology and testing of immune function; the body of literature describing immunological outcomes after childhood cancer therapy, with an emphasis on the risk of infection, when is testing indicated, and preventive strategies; and knowledge gaps and opportunities for future research.

Original languageEnglish
Pages (from-to)284-294
Number of pages11
JournalThe Lancet Child and Adolescent Health
Issue number4
StatePublished - Apr 2021
Externally publishedYes


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