Reconstruction of the immune system after unrelated or partially matched T-cell-depleted bone marrow transplantation in children: Immunophenotypic analysis and factors affecting the speed of recovery

Academic Article

Abstract

  • We prospectively studied immune reconstitution in 102 children who underwent T-lymphocyte depleted bone marrow transplants using either closely matched unrelated donors or partially matched familial donors by assaying total lymphocyte counts (TLC}, T-cell subsets, B cells, and natural killer cells. TLC, CD3+, and CD4+ T-cell counts remained depressed until 2 to 3 years posttransplant, whereas CD8+ T-cell counts normalized by 18 months, resulting in an inverted CD4:CD8 ratio until 12 months posttransplant. Although the percentage of NK cells was elevated early posttransplant, their absolute numbers remained normal. CD20 + B cells were depressed until 12 to 18 months posttransplant. Factors affecting immunophenotypic recovery were analyzed by non-parametric statistics. Younger patients tended to have higher TLC posttransplant. Higher marrow cell doses were not associated with hastened immunophenotypic recovery. Graft-versus-host disease (GVHD) and/or its treatment significantly delayed the immune reconstitution of CD3 + , CD4+, and CD20+ cells. The presence of cytomegalovirus was associated with increased CD8+ counts and a decrease in the percentages of CD4 + and CD20+ cells.
  • Published In

  • Blood  Journal
  • Author List

  • Kook H; Goldman F; Padley D; Giller R; Rumelhart S; Holida M; Lee N; Peters C; Comito M; Huling D
  • Start Page

  • 1089
  • End Page

  • 1097
  • Volume

  • 88
  • Issue

  • 3