title: Immune reconstitution after autologous purged bone marrow transplantation in children.
abstract: OBJECTIVE
  Immune reconstitution was studied in 30 children who had received purged autologous bone marrow transplantation for neuroblastoma or acute myeloid leukemia (AML).
  
  
  METHODS
  Patients with neuroblastoma received high-dose chemotherapy and total body irradiation, and patients with AML received chemotherapy alone. Marrows were purged ex vivo with either antineuroblastoma monoclonal antibodies (neuroblastoma) or 4-hydroperoxycyclophosphamide (AML). Lymphocyte subsets, mitogen stimulation studies, and immunoglobulin levels were studied every 4 months.
  
  
  RESULTS
  There were no significant differences between the two groups of patients in lymphocyte number or subsets over time. In both groups, CD2+ and CD4+ cells were below normal in 33% of patients at 12 months. CD4+/CD8+ ratios were below normal for up to 8 months after transplantation and natural killer cells were elevated for up to 2 years in most patients. Median IgG and IgA levels were below the age mean even at 2 years after transplantation, although patients with AML had significantly higher IgG levels at 12 months compared with those with neuroblastoma. Lymphocyte proliferative responses to mitogens were markedly reduced at 4 months but returned to normal at 8 months. Despite the delay in immune reconstitution, there were no life-threatening infections.
  
  
  CONCLUSIONS
  There appeared to be little difference in the overall kinetics of immune reconstitution between the children with neuroblastoma, who received total body irradiation and high-dose chemotherapy, and those with AML, who received high-dose chemotherapy alone as their pretransplant preparative regimen.
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, PA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Kamani
authors.forename: A
authors.initials: A
authors.lastname: Kattamis
authors.forename: A
authors.initials: A
authors.lastname: Carroll
authors.forename: D
authors.initials: D
authors.lastname: Campbell
authors.forename: N
authors.initials: N
authors.lastname: Bunin
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D016470:Bacteremia / Q000209:etiology; D016465:Bone Marrow Purging / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology*; D002644:Chickenpox / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000145:classification / Q000276:immunology / Q000378:metabolism; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D009447:Neuroblastoma / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D009894:Opportunistic Infections / Q000209:etiology
chemical_list: D007074:Immunoglobulin G