Immune reconstitution following transplantation of selected hematopoietic stem cells.
The use of selected stem cell grafts has recently entered the era of clinical application. Its potential interest lies in the decreased contamination of the graft by tumor cells in the autologous graft setting and in the depletion of T-lymphocytes from the graft in the allogeneic situation. Very few and only phenotypic studies of immunologic recovery post selected stem cell transplant have been performed. Most studies conclude an absence of influence of stem cell selection on quantitative neutrophil, NK, B-lymphocyte and CD8+ T-lymphocyte recovery. CD4+ T-lymphocyte recovery seems delayed in half of the studies, particularly in the context of allogeneic unrelated donor or HLA-mismatched transplants and this could explain viral infections frequently noted in this situation. Additional follow-up and comparative studies with non selected grafts including functional tests of immunity will be required to better assess the relationship of immune recovery post graft to the age of the patient, the type of donor and HLA compatibility between donor and recipient, the underlying pathology and the number of reinfused stem cells and accessory cells.
Archimbaud
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Service d'Hématologie, Hôpital Edouard Herriot, Lyon.
D000222:Adaptation, Physiological; D001402:B-Lymphocytes / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007109:Immunity / Q000502:physiology*; D007694:Killer Cells, Natural / Q000276:immunology; D018655:Lymphocyte Count; D009504:Neutrophils / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology