Immune reconstitution following allogeneic peripheral blood progenitor cell transplantation: comparison of recipients of positive CD34+ selected grafts with recipients of unmanipulated grafts

Exp Hematol. 1999 Mar;27(3):561-8. doi: 10.1016/s0301-472x(98)00029-0.

Abstract

We compared the kinetic recovery of lymphocytes and their subsets in two groups of patients submitted to allogeneic peripheral blood progenitor cell transplantation (allo-PBT): those receiving lymphocyte-depleted leukaphereses by positive selection of CD34+ cells (group 1, n = 18) and those receiving unmanipulated leukaphereses (group 2, n = 15). Patients were conditioned with cyclophosphamide (120 mg/kg) and fractioned total body irradiation (13 Gy, group 1; 12 Gy, group 2). The mean number (x 10(6)/kg) of CD34+ and CD3+ cells infused was 4.0 and 0.67, respectively, in group 1 patients, and 4.7 and 274, respectively, for group 2 patients. Graft-versus-host disease prophylaxis consisted of cyclosporin A + methylprednisolone for group 1 and cyclosporin A + methotrexate for group 2. Median follow-up was 7 months (range 2-8 months) for both groups. During the first 6 months post-transplant, CD4+ cell counts were lower in group 1 as compared with group 2 (p = 0.014, 0.010, 0.011, 0.0003, and 0.052 at 0.5, 1, 2, 3, and 6 months, respectively), whereas there was no difference at 8 months. The number of CD4+CD45RA+ cells was very low throughout the study in both groups, being lower in group 1 than in group 2, especially during the first 3 months post-transplant (p = 0.007 and 0.0006 at 1 and 3 months). Normal levels of CD8+ cells were reached by 1 month post-transplant in both groups. TCR gamma delta + cell counts were lower in group 1 than in group 2 during the first 4 months post-transplant (p = 0.001, 0.004, and 0.04 at 1, 3, and 4 months). A normal number of natural killer cells (CD3-CD56+) was achieved 1 month post-transplant in both groups. B lymphocytes (CD19+) showed low or undetectable counts throughout the first 4 months in both groups, achieving the normal range at 8 months. These results show that, during the first 6 months following allo-PBT with CD34+ selected grafts, the number of CD4+, CD4+CD45RA+, and TCR gamma delta + cells is significantly lower than after unmanipulated allo-PBT; these differences disappeared at 8 months. In contrast, there are no differences between transplant groups in the recovery of CD8+, CD19+, and natural killer cells.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD19 / analysis
  • Antigens, CD34 / analysis*
  • B-Lymphocyte Subsets
  • CD4 Antigens / analysis
  • CD8 Antigens / analysis
  • Cell Separation / methods*
  • Chimera
  • Cyclophosphamide
  • Cyclosporine / therapeutic use
  • Female
  • Graft Survival*
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunophenotyping
  • Infections / etiology
  • Killer Cells, Natural
  • Kinetics
  • Leukapheresis*
  • Leukocyte Common Antigens / analysis
  • Lymphocyte Count
  • Lymphocyte Depletion*
  • Lymphocyte Subsets*
  • Male
  • Methotrexate / therapeutic use
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Prospective Studies
  • T-Lymphocyte Subsets
  • Time Factors
  • Transplantation Conditioning
  • Whole-Body Irradiation

Substances

  • Antigens, CD19
  • Antigens, CD34
  • CD4 Antigens
  • CD8 Antigens
  • Cyclosporine
  • Cyclophosphamide
  • Leukocyte Common Antigens
  • Methylprednisolone
  • Methotrexate