Lymphocyte subset reconstitution after unrelated cord blood or bone marrow transplantation in children.
We report the post-transplant lymphocyte subset recovery of 226 children treated with Unrelated Cord Blood transplant (UCBT) (n = 112) or Unrelated Bone Marrow Transplant (UBMT) (n = 114) for malignant or non-malignant diseases. Absolute numbers of natural killer (NK), B and T cells were monitored by flow cytometry up to 5 years post-transplant. Immunological endpoints were: time to achieve a CD3(+) cell count > 0·5 and 1·5 × 10⁹/l, CD4(+) > 0·2 and 0·5 × 10⁹/l, CD8(+) > 0·25 ×10⁹/l, CD19(+) > 0·2 × 10⁹/l, NK > 0·1 × 10⁹/l. These endpoints were analysed through the use of cumulative incidence curves in the context of competing risks. CD8(+) T cell recovery was delayed after UCBT with a median time to reach CD8(+) T cells > 0·25 × 10⁹/l of 7·7 months whereas it was 2·8 months in UBMT (P < 0·001). B cell recovery was better in UCBT, with a median time to reach CD19(+) cells > 0·2 × 10⁹/l of 3·2 months in UCBT and 6·4 months in UBMT (P = 0·03). Median time for CD4(+) T cell and NK cell recovery was similar in UCBT and UBMT. CD4(+) T cells recovery was negatively correlated to age (better reconstitution in younger patients, P = 0·002). CD8(+) T cells recovery was shorter in recipients with a positive cytomegalovirus serology (P =0·001).
Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, France. cecilerenard@wanadoo.fr
Cécile
C
Rénard
Vincent
V
Barlogis
Valérie
V
Mialou
Claire
C
Galambrun
Delphine
D
Bernoux
Marie Pierre
MP
Goutagny
Laurence
L
Glasman
Anderson Dieudonné
AD
Loundou
Françoise
F
Poitevin-Later
Françoise
F
Dignat-George
Valérie
V
Dubois
Christophe
C
Picard
Christian
C
Chabannon
Yves
Y
Bertrand
Gérard
G
Michel
D000293:Adolescent; D001402:B-Lymphocytes / Q000276:immunology; D016026:Bone Marrow Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D006402:Hematologic Diseases / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007694:Killer Cells, Natural / Q000276:immunology; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D009894:Opportunistic Infections / Q000276:immunology; D016176:T-Lymphocyte Subsets / Q000276:immunology; D016896:Treatment Outcome