title: Improved immune reconstitution after allotransplantation of peripheral blood stem cells instead of bone marrow.
abstract: Clinical studies are evaluating possible advantages of allogeneic peripheral blood stem cell transplantation (PBSCT) over bone marrow transplantation (BMT). We compared immune reconstitution after PBSCT (n = 20) and BMT (n = 20) in terms of lymphocyte subset counts and proliferative in vitro responses to mitogens and recall antigens (follow-up: 5 to 11 months posttransplant). Additionally, 10 PBSC harvests and 10 marrow harvests were analyzed for their composition of immunocompetent cells. Compared with BMT patients, PBSCT recipients had PB counts of naive (CD4+CD45RA+) and memory (CD4+CD45RO+) helper T cells and of B cells (CD19+) that were elevated (P < .003, P < .001, and P < .004, respectively) and proliferative responses to phytohemagglutinin (P < .0001), pokeweed mitogen (P < .02), Tetanus toxoid (P < .0005), and Candida (P < .004) that were increased. PBSCT recipients received a mean of 188 (range, 44 to 280) x 10(6) naive helper T cells and 169 (range, 18 to 296) x 10(5) memory helper T cells per kilogram; the corresponding numbers for BMT recipients were 11 (range, 4 to 24) and 10 (range, 1 to 22) x 10(5) cells per kilogram, respectively. The question of whether the documented improved in vitro immune competence after PBSCT is associated with a lower incidence of infectious complications in vivo still needs further study.
authors.affiliation: Institute of Immunology, University Hospital of Essen, Germany.
authors.forename: H D
authors.initials: HD
authors.lastname: Ottinger
authors.forename: D W
authors.initials: DW
authors.lastname: Beelen
authors.forename: B
authors.initials: B
authors.lastname: Scheulen
authors.forename: U W
authors.initials: UW
authors.lastname: Schaefer
authors.forename: H
authors.initials: H
authors.lastname: Grosse-Wilde
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation; D002175:Candida / Q000276:immunology; D005260:Female; D006085:Graft Survival; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007121:Immunocompetence; D007156:Immunologic Memory; D016130:Immunophenotyping; D008213:Lymphocyte Activation; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D008934:Mitogens / Q000494:pharmacology; D011446:Prospective Studies; D018139:Simplexvirus / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology; D013997:Time Factors
chemical_list: D008934:Mitogens; D013745:Tetanus Toxoid