title: Transplantation of autologous peripheral blood progenitor cells: impact of CD34-cell selection on immunological reconstitution.
abstract: Peripheral blood progenitor cells (PBPC) represent an ideal source of stem cells for autologous transplantation because of technical advantages and more favourable engraftment kinetics. The reconstituion of a functional immune system occurs earlier in patients transplanted with cytokine-mobilized autologous PBPC compared with bone marrow; because of the greater T-cell content in PBPC products, donor-derived antigen-specific T-cells transferred with the graft might contribute to short-term immunity in transplant recipients. Despite a prompt reconstitution of B- and T-cell numbers, both B- and T-cell function are profoundly impaired for a prolonged period of time after PBPC infusion. The positive selection of CD34+ cells might provide effective tumor cell purging without compromising hematopoietic recovery in patients with acute leukemia, multiple myeloma, breast cancer and non-Hodgkin's lymphoma, whose autografts have been reported to contain malignant cells which might promote disease relapse. However, the incidence of viral infections in the early posttransplant period might be increased after CD34-selected compared with unmanipulated PBPC transplants, as a result of the lack of accessory and immune cells in the graft. The purpose of this review is to provide an update on immunological reconstitution after transplantation of autologous PBPC; in particular, emphasis will be placed on the mechanisms of immune dysfunction after the infusion of unmanipulated and CD34-selected autografts.
authors.affiliation: Department of Hematology, Catholic University Medical School, Rome, Italy. sergiorutella@tin.it
authors.forename: S
authors.initials: S
authors.lastname: Rutella
authors.forename: L
authors.initials: L
authors.lastname: Pierelli
authors.forename: S
authors.initials: S
authors.lastname: Sica
authors.forename: C
authors.initials: C
authors.lastname: Rumi
authors.forename: G
authors.initials: G
authors.lastname: Leone
mesh_terms: D018952:Antigens, CD34 / Q000032:analysis*; D017209:Apoptosis; D001402:B-Lymphocytes / Q000276:immunology; D016207:Cytokines / Q000096:biosynthesis; D003713:Dendritic Cells / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016130:Immunophenotyping; D007694:Killer Cells, Natural / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34; D016207:Cytokines