title: Immune reconstitution after combined haploidentical and umbilical cord blood transplant.
abstract: Umbilical cord blood (UCB) stem cells are frequently employed for allogeneic stem cell transplant, but delayed myeloid and lymphoid immune reconstitution leads to increased risk of infections. We recently reported the clinical results of 45 patients enrolled on a pilot study combining UCB with a human leukocyte antigen (HLA)-haploidentical donor with reduced-intensity conditioning who showed rapid neutrophil and platelet recovery. We report here preliminary immune reconstitution data of these patients. Patients were assessed for lymphocyte subsets, T-cell diversity, Cylex ImmuKnow assay and serological response to pneumococcal vaccination. Natural killer (NK)-cell and B-cell reconstitution were rapid at 1 month and 3 months, respectively. T-cell recovery was delayed, with a gradual increase in the number of T-cells starting around 6 months post-transplant, and was characterized by a diverse polyclonal T-cell repertoire. Overall, immune reconstitution after haplo-cord transplant is similar to that seen after cord blood transplant, despite infusion of much lower cord blood cell dose.
authors.affiliation: Section of Hematology/Oncology, Department of Medicine, The University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Jain
authors.forename: Hongtao
authors.initials: H
authors.lastname: Liu
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Artz
authors.forename: John
authors.initials: J
authors.lastname: Anastasi
authors.forename: Olatoyosi
authors.initials: O
authors.lastname: Odenike
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Godley
authors.forename: Loren
authors.initials: L
authors.lastname: Joseph
authors.forename: Susana
authors.initials: S
authors.lastname: Marino
authors.forename: Justin
authors.initials: J
authors.lastname: Kline
authors.forename: Vu
authors.initials: V
authors.lastname: Nguyen
authors.forename: Viviane
authors.initials: V
authors.lastname: Schouten
authors.forename: Rangesh
authors.initials: R
authors.lastname: Kunnavakkam
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.forename: Wendy
authors.initials: W
authors.lastname: Stock
authors.forename: Jodie
authors.initials: J
authors.lastname: Ulaszek
authors.forename: Peter A
authors.initials: PA
authors.lastname: Savage
authors.forename: Amittha
authors.initials: A
authors.lastname: Wickrema
authors.forename: Koen
authors.initials: K
authors.lastname: van Besien
mesh_terms: D000328:Adult; D000368:Aged; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D005260:Female; D006085:Graft Survival; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000150:complications / Q000276:immunology / Q000628:therapy; D006410:Hematopoiesis / Q000276:immunology*; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood / Q000276:immunology; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000276:immunology; D011948:Receptors, Antigen, T-Cell / Q000378:metabolism; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014777:Virus Diseases / Q000150:complications / Q000276:immunology; D055815:Young Adult
chemical_list: D007132:Immunoglobulin Isotypes; D022242:Pneumococcal Vaccines; D011948:Receptors, Antigen, T-Cell