Immune reconstitution after purified autologous and allogeneic blood stem cell transplantation compared with unmanipulated bone marrow transplantation in children

Br J Haematol. 2006 Oct;135(1):76-84. doi: 10.1111/j.1365-2141.2006.06244.x. Epub 2006 Aug 22.

Abstract

Immune reconstitution is critical for the long-term success of haematopoietic stem cell transplantation (HSCT). We prospectively analysed immune reconstitution parameters after transplantation of autologous (group 1; n = 10) and allogeneic (group 2; n = 12) highly purified CD34+ peripheral blood stem cells (PBSC) and unmanipulated allogeneic bone marrow (BM) (group 3; n = 9) in children. Median follow-up after HSCT was 56 (group 1), 61 (group 2), and 40.5 months (group 3). Median CD34-cell dose transplanted in the three groups was 9.4 x 10(6)/kg, 20.3 x 10(6)/kg, and 4.25 x 10(6)/kg recipient's body weight (BW) respectively. Complete haematopoietic engraftment was seen in all patients without any significant differences between the three groups. T-cell reconstitution at 6 months was significantly delayed in autologous peripheral blood stem cell transplantation (PBSCT) compared with allogeneic BM transplantation (P < 0.028) and allogeneic PBSCT (P < 0.034). At 3 months after transplantation numbers of CD56+/3- natural killer cells were higher in the allogeneic PBSC group (P < 0.01) compared with the BM group. The numbers of proven bacterial and viral infections were equally distributed between the three groups. In conclusion, recipients of allogeneic highly purified CD34+ PBSC or unmanipulated BM have higher lymphocyte subset counts at 6 months after transplantation than recipients of autologous CD34-selected PBSC. Infection rates and outcome, however, were not significantly different.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD34 / blood
  • Bone Marrow Transplantation / immunology*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Graft Survival / immunology
  • Graft vs Host Disease / prevention & control
  • Hematologic Diseases / immunology
  • Hematologic Diseases / therapy*
  • Humans
  • Immunity, Cellular
  • Immunocompromised Host
  • Infant
  • Killer Cells, Natural / immunology
  • Lymphocyte Count
  • Male
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Opportunistic Infections / immunology
  • Peripheral Blood Stem Cell Transplantation*
  • Prospective Studies
  • T-Lymphocyte Subsets / immunology
  • Transplantation, Autologous
  • Transplantation, Homologous

Substances

  • Antigens, CD34