Immune reconstitution after purified autologous and allogeneic blood stem cell transplantation compared with unmanipulated bone marrow transplantation in children.
Immune reconstitution is critical for the long-term success of haematopoietic stem cell transplantation (HSCT). We prospectively analysed immune reconstitution parameters after transplantation of autologous (group 1; n = 10) and allogeneic (group 2; n = 12) highly purified CD34+ peripheral blood stem cells (PBSC) and unmanipulated allogeneic bone marrow (BM) (group 3; n = 9) in children. Median follow-up after HSCT was 56 (group 1), 61 (group 2), and 40.5 months (group 3). Median CD34-cell dose transplanted in the three groups was 9.4 x 10(6)/kg, 20.3 x 10(6)/kg, and 4.25 x 10(6)/kg recipient's body weight (BW) respectively. Complete haematopoietic engraftment was seen in all patients without any significant differences between the three groups. T-cell reconstitution at 6 months was significantly delayed in autologous peripheral blood stem cell transplantation (PBSCT) compared with allogeneic BM transplantation (P < 0.028) and allogeneic PBSCT (P < 0.034). At 3 months after transplantation numbers of CD56+/3- natural killer cells were higher in the allogeneic PBSC group (P < 0.01) compared with the BM group. The numbers of proven bacterial and viral infections were equally distributed between the three groups. In conclusion, recipients of allogeneic highly purified CD34+ PBSC or unmanipulated BM have higher lymphocyte subset counts at 6 months after transplantation than recipients of autologous CD34-selected PBSC. Infection rates and outcome, however, were not significantly different.
Schwinger
Wolfgang
W
Division of Paediatric Haematology/Oncology, Department of Paediatrics; Medical University of Graz, Graz, Austria. wolfgang.schwinger@medunigraz.at
Weber-Mzell
Daniela
D
Zois
Birgit
B
Rojacher
Tanja
T
Benesch
Martin
M
Lackner
Herwig
H
Dornbusch
Hans Juergen
HJ
Sovinz
Petra
P
Moser
Andrea
A
Lanzer
Gerhard
G
Schauenstein
Konrad
K
Ofner
Petra
P
Handgretinger
Rupert
R
Urban
Christian
C
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000097:blood; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000276:immunology; D006086:Graft vs Host Disease / Q000517:prevention & control; D006402:Hematologic Diseases / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007111:Immunity, Cellular; D016867:Immunocompromised Host; D007223:Infant; D007694:Killer Cells, Natural / Q000276:immunology; D018655:Lymphocyte Count; D008297:Male; D009369:Neoplasms / Q000276:immunology / Q000628:therapy*; D009894:Opportunistic Infections / Q000276:immunology; D036102:Peripheral Blood Stem Cell Transplantation; D011446:Prospective Studies; D016176:T-Lymphocyte Subsets / Q000276:immunology; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D018952:Antigens, CD34