Neutrophil function in children following allogeneic hematopoietic stem cell transplant.
HSCT is a lifesaving procedure for children with malignant and non-malignant conditions. The conditioning regimen renders the patient severely immunocompromised and recovery starts with neutrophil (PMN) engraftment. We hypothesize that children demonstrate minimal PMN dysfunction at engraftment and beyond, which is influenced by the stem cell source and the conditioning regimen. Peripheral blood was serially collected from children at 1 to 12 months following allogeneic HSCT. PMN superoxide (O2-) production, degranulation (elastase), CD11b surface expression, and phagocytosis were assessed. Twenty-five patients, mean age of 10.5 yr with 65% males, comprised the study and transplant types included: 14 unrelated cord blood stem cells (cords), seven matched related bone marrow donors, three matched unrelated bone marrow donors, and one peripheral blood progenitor cells. Engraftment occurred at 24 days. There were no significant differences between controls and patients in PMN O2- production, phagocytosis, CD11b surface expression, and total PMN elastase. Elastase release was significantly decreased <6 months vs. controls (p < 0.05) and showed normalization by six months for cords only. The conditioning regimen did not affect PMN function. PMN function returns with engraftment, save elastase release, which occurs later related to the graft source utilized, and its clinical significance is unknown.
Research Laboratory, Bonfils Blood Center, Denver, CO, USA.|Department of Pediatrics, School of Medicine, University of Colorado, Denver, Aurora, CO, USA.
Michael W
MW
Kent
Research Laboratory, Bonfils Blood Center, Denver, CO, USA.|Department of Surgery, School of Medicine, University of Colorado, Denver, Aurora, CO, USA.
Marguerite R
MR
Kelher
Research Laboratory, Bonfils Blood Center, Denver, CO, USA.|Department of Pediatrics, School of Medicine, University of Colorado, Denver, Aurora, CO, USA.|Department of Surgery, School of Medicine, University of Colorado, Denver, Aurora, CO, USA.
Christopher C
CC
Silliman
Department of Pediatrics, School of Medicine, University of Colorado, Denver, Aurora, CO, USA.
Ralph
R
Quinones
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D009504:Neutrophils / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D010196:Pancreatic Elastase / Q000097:blood; D010587:Phagocytosis; D011184:Postoperative Period; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods; D055815:Young Adult
D015415:Biomarkers; D010196:Pancreatic Elastase
elastase release; hematopoietic stem cell transplantation; neutrophil dysfunction