Low B-cell and monocyte counts on day 80 are associated with high infection rates between days 100 and 365 after allogeneic marrow transplantation.
To ascertain which mononuclear cell subset deficiency plays a role in the marrow transplant recipient's susceptibility to infections, mononuclear cell subset counts were prospectively determined in 108 patients on day 80. Infections occurring between day 100 and 365 were recorded by an investigator blinded to the subset counts. In univariate analyses, the counts of the following subsets showed a significant inverse correlation with infection rates: total B cells, IgD(+) B cells, IgD(-) B cells, total CD4 T cells, CD28(+) CD4 T cells, CD28(-) CD4 T cells, CD45RA(low/-) CD4 T cells and monocytes. In multivariate analyses, the counts of the following subsets remained significantly inversely correlated with the infection rates: total B cells (P =.0004) and monocytes (P =.009). CD28(-) CD8 T-cell counts showed no correlation with infection rates. In conclusion, the susceptibility of patients to infections late posttransplant may be due in part to the slow reconstitution of B cells and monocytes.
Storek
J
J
Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA, USA. jstorek@fhcrc.org
Espino
G
G
Dawson
M A
MA
Storer
B
B
Flowers
M E
ME
Maloney
D G
DG
D000293:Adolescent; D000328:Adult; D001402:B-Lymphocytes; D016026:Bone Marrow Transplantation; D002648:Child; D003141:Communicable Diseases / Q000453:epidemiology*; D005500:Follow-Up Studies; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008875:Middle Aged; D009000:Monocytes; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D013997:Time Factors; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation
D007166:Immunosuppressive Agents