Frequent viral infections and delayed CD4+ cell recovery following CD34+ cell-selected autologous peripheral blood stem cell transplantation.
This study compares the reconstitution of T-lymphocyte subsets and the incidence of infections following CD34+ cell-selected autologous peripheral blood stem cell transplantation (PBSCT) (n = 15) and unselected auto-PBSCT (n = 16). In the CD34+ cell-selected auto-PBSCT group, the mean count of CD4+ cells had significantly decreased at 30 days after transplantation compared with pretransplantation, and did not reach the safe minimum level of 0.2 x 10(9)/l even at 90 days after transplantation. Compared with unselected auto-PBSCT, CD4+ cell reconstitution after CD34+ cell-selected auto-PBSCT was significantly delayed within the first 90 days after transplantation. Cytomegalovirus infections developed more frequently after CD34+ cell-selected auto-PBSCT than after unselected auto-PBSCT (nine patients vs. two patients, P = 0.0057). Hemorrhagic cystitis due to adenovirus type 11 infections developed in three patients who underwent CD34+ cell-selected auto-PBSCT. Positive correlation between the counts of reinfused CD34+ cells and the counts of CD4+ cells were found at 90 days after CD34+ cell-selected auto-PBSCT. No significant difference was found in the frequency of viral infections, however, between patients transplanted with > 2 x 10(6)/kg of CD34+ cells and those transplanted with < 2 x 10(6)/kg of CD34+ cells. Careful monitoring for viral infection is necessary after CD34+ cell-selected auto-PBSCT.
Takeshima
M
M
Department of Internal Medicine, Toyama Prefectural Central Hospital, Japan.
Takamatsu
H
H
Iida
M
M
Mochizuki
Y
Y
Okumura
H
H
Yoshida
T
T
D000368:Aged; D018952:Antigens, CD34; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D006085:Graft Survival / Q000276:immunology; D019337:Hematologic Neoplasms / Q000276:immunology / Q000628:therapy*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014777:Virus Diseases / Q000209:etiology*
D018952:Antigens, CD34