title: Reconstitution rate of absolute CD8+ T lymphocyte counts affects overall survival after pediatric allogeneic hematopoietic stem cell transplantation.
abstract: Immune reconstitution after allogeneic stem cell transplantation protects against opportunistic infections and disease relapse. Identifying the most protective lymphocyte subset would have implications of adoptive immunotherapy. We followed up a case series of 34 allogeneic transplantations for pediatric leukemias, aplastic anemias, or solid tumors. Regardless of baseline hematologic disorder, the speed of reconstitution of cytotoxic CD8 T lymphocytes and the achieving of the 10th percentile of normal CD4 T lymphocytes (but not B lymphocytes or natural killer cells) conditioned overall survival. The source of hematopoietic stem cells (peripheral blood vs bone marrow) and the occurrence of graft-versus-host disease (either acute or chronic) did not impact on immune reconstitution. Larger case series are needed to confirm the pivotal role of cytotoxic CD8 T lymphocytes in overall survival.
authors.affiliation: U.O. Oncoematologia Pediatrica †U.O. Immunoematologia S.S.N., Azienda Ospedaliera Universitaria Pisana, Pisa Italy. r.giannelli@ao-pisa.toscana.it
authors.forename: Rossella
authors.initials: R
authors.lastname: Giannelli
authors.forename: Maria
authors.initials: M
authors.lastname: Bulleri
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Menconi
authors.forename: Gabriella
authors.initials: G
authors.lastname: Casazza
authors.forename: Daniele
authors.initials: D
authors.lastname: Focosi
authors.forename: Sayla
authors.initials: S
authors.lastname: Bernasconi
authors.forename: Claudio
authors.initials: C
authors.lastname: Favre
mesh_terms: D000293:Adolescent; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D019337:Hematologic Neoplasms / Q000276:immunology / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D018655:Lymphocyte Count; D008297:Male; D011446:Prospective Studies; D014184:Transplantation, Homologous