The kinetics of immune reconstitution after cord blood transplantation and selected CD34+ stem cell transplantation in children: comparison with bone marrow transplantation.
The present study compares immune reconstitution after allogeneic cord blood transplantation (CBT) and CD34+ stem cell transplantation (CD34-SCT) with that after bone marrow transplantation (BMT). Eighty-eight children who underwent CBT (20 patients), BMT (58), and CD34-SCT (10) were enrolled, and lymphocytes and T-, B-, and natural killer-lymphocyte subsets were monitored for more than 5 years after transplantation. CBT recipients showed significant ircreases in (1) total lymphocyte counts (P < .001), (2) CD4+/CD8+ cell ratios (P < .01), (3) CD4+ and CD4+CD45RA+ cells (P < .001), (4) CD8+CD11b+ cells (P < .001), and (5) CD19+ and CD19+CD5+ cells (P < .0001) and marked decreases in the frequencies of CD8+ and CD8+CD11b- cells (P < .0001). CD34-SCT recipients showed lower lymphocyte counts in the first 6 months and an emergence of lymphocyte and CD4+CD45RA+ cells at approximately 9 months and 1 year. Both CBT and CD34-SCT recipients showed increased frequencies of CD56+ cells at 1 month (CD34-SCT versus BMT, P < .001) but decreased frequencies after 6 months (CBT versus BMT, P < .001). Lymphoproliferative responses to exogenous interleukin 2 were constantly lower in CBT and CD34-SCT recipients than in BMT recipients. These results suggest that the delay in immune reconstitution after CBT in the early phase was mainly qualitative and related to the immaturity of cells, whereas the delay in CD34-SCT was mainly quantitative in the first several months.
Inoue
Hiroyasu
H
Department of Pediatrics, Tokai University School of Medicine, Isehara, Kanagawa, Japan. inouehpd@is.icc.u-tokai.ac.jp
Yasuda
Yukiharu
Y
Hattori
Kinya
K
Shimizu
Takashi
T
Matsumoto
Masae
M
Yabe
Miharu
M
Yabe
Hiromasa
H
Tsuchida
Fumiko
F
Tanaka
Yumiko
Y
Hosoi
Gaku
G
Sako
Masahiro
M
Kato
Shunichi
S
D000293:Adolescent; D018952:Antigens, CD34; D001402:B-Lymphocytes; D016026:Bone Marrow Transplantation / Q000592:standards; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007107:Immune System / Q000166:cytology / Q000254:growth & development*; D016130:Immunophenotyping; D007223:Infant; D007376:Interleukin-2 / Q000494:pharmacology; D007694:Killer Cells, Natural; D007700:Kinetics; D008213:Lymphocyte Activation / Q000187:drug effects; D016131:Lymphocyte Subsets; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000592:standards*; D013601:T-Lymphocytes
D018952:Antigens, CD34; D007376:Interleukin-2