title: Immune recovery in children undergoing allogeneic stem cell transplantation: absolute CD8+ CD3+ count reconstitution is associated with survival.
abstract: To evaluate the correlation between kinetics of immune reconstitution and survival, we prospectively evaluated lymphocyte subsets in 32 paediatric patients undergoing allogeneic stem cell transplantation (SCT) for haematological malignancies. Four-colour flow cytometric analysis was performed at short intervals with a median follow-up of 4 years post SCT. A total of 50% of patients reached age-matched 5th percentile of natural killer, cytotoxic T, B and helper T cells 4, 9, 20 and 28 weeks after SCT, respectively, which increased to more than 80% within 1 year after SCT. Transplantation of peripheral blood stem cells (PBSC) seemed to elicit the fastest reconstitution of CD3+, CD4+ CD3+, CD8+ CD3+ and naïve T cells compared to bone marrow (BM) or CD34-selected PBSC, which did not differ. Most importantly, we observed a significantly higher number of survivors among patients whose CD8+ CD3+ absolute counts rose above the 5th percentile of age-matched normal levels during the first year post SCT compared to patients who never reached these levels (19/25 vs 0/7, P<0.001). This was still present in both subgroups, BM- and CD34-selected grafts (P=0.03, 0.02). These results from a small patient sample underline the importance of particular lymphocyte subsets for the outcome of children undergoing SCT. A larger study with detailed subset analysis is underway.
authors.affiliation: Paediatric Haematology and Oncology, Johann-Wolfgang-Goethe University, Frankfurt, Germany. koehl@em.uni-frankfurt.de
authors.forename: U
authors.initials: U
authors.lastname: Koehl
authors.forename: K
authors.initials: K
authors.lastname: Bochennek
authors.forename: S Y
authors.initials: SY
authors.lastname: Zimmermann
authors.forename: T
authors.initials: T
authors.lastname: Lehrnbecher
authors.forename: J
authors.initials: J
authors.lastname: Sörensen
authors.forename: R
authors.initials: R
authors.lastname: Esser
authors.forename: C
authors.initials: C
authors.lastname: Andreas
authors.forename: C
authors.initials: C
authors.lastname: Kramm
authors.forename: H P
authors.initials: HP
authors.lastname: Grüttner
authors.forename: E
authors.initials: E
authors.lastname: Falkenberg
authors.forename: A
authors.initials: A
authors.lastname: Orth
authors.forename: P
authors.initials: P
authors.lastname: Bader
authors.forename: D
authors.initials: D
authors.lastname: Schwabe
authors.forename: T
authors.initials: T
authors.lastname: Klingebiel
mesh_terms: D000293:Adolescent; D001854:Bone Marrow Cells; D017252:CD3 Complex / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes; D016827:CD8 Antigens / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D020127:Recovery of Function / Q000276:immunology*; D015996:Survival Rate; D014184:Transplantation, Homologous
chemical_list: D017252:CD3 Complex; D016827:CD8 Antigens