Korean J Hematol.  2012 Mar;47(1):44-52. 10.5045/kjh.2012.47.1.44.

Factors influencing lymphocyte reconstitution after allogeneic hematopoietic stem cell transplantation in children

• Bae KW
• Kim BE
• Koh KN
• Im HJ
• Seo JJ

• KMID: 2251970
• DOI: http://doi.org/10.5045/kjh.2012.47.1.44

Abstract

BACKGROUND
Immune reconstitution (IR) after hematopoietic stem cell transplantation (HSCT) reduces transplantation-related complications such as infection and improves HSCT outcomes.
METHODS
We retrospectively analyzed IR of lymphocyte subpopulations in 38 pediatric patients for hematologic malignant diseases after allogeneic HSCT from April 2006 to July 2008. T-cell-, B-cell-, and natural killer (NK) cell-associated antigens were assayed in peripheral blood by flow cytometry analysis of 5 lymphocyte subsets, CD3+, CD3+/CD4+, CD4+/CD8+, CD16+/CD56+, and CD19+, before and 3 and 12 months after transplantation.
RESULTS
Reconstitutions of CD16+/CD56+ and CD3+/CD8+ lymphocytes were achieved rapidly, whereas that of CD3+/CD19+ lymphocytes occurred later. Age was not related to reconstitution of any lymphocyte subset. Total body irradiation (TBI) and anti-thymocyte globulin (ATG) administration were related to delayed reconstitution of total lymphocytes and CD3+ lymphocytes, respectively. Reconstitutions of CD3+/CD4+ lymphocytes and CD3+/CD8+ lymphocytes were significantly delayed in patients who received umbilical cord blood stem cells. In patients with chronic graft-versus-host disease (cGVHD), recovery of the total lymphocyte count and CD19+ lymphocytes at 3 months post-transplant were significantly delayed. However, acute GVHD (aGVHD) and cytomegalovirus (CMV) reactivation did not influence the IR of any lymphocyte subset. Further, delayed reconstitution of lymphocyte subsets did not correspond to inferior survival outcomes in this study.
CONCLUSION
We observed that some lymphocyte reconstitutions after HSCT were influenced by the stem cell source and preparative regimens. However, delayed CD19+ lymphocyte reconstitution may be associated with cGVHD.

Keyword

Immune reconstitution; Hematopoietic stem cell transplantation; Children; Lymphocyte subset

MeSH Terms

Antilymphocyte Serum
Child
Cytomegalovirus
Fetal Blood
Flow Cytometry
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Humans
Lymphocyte Count
Lymphocyte Subsets
Lymphocytes
Retrospective Studies
Stem Cells
Whole-Body Irradiation
Antilymphocyte Serum

Figure

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  Fig. 1 Patients included in the study.

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