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Allografting

Peripheral T-cell expansion and low infection rate after reduced-intensity conditioning and allogeneic blood stem cell transplantation

Bone Marrow Transplantation volume 35, pages 859–868 (2005)Cite this article

Summary:

Peripheral blood stem cell transplantation after reduced-intensity conditioning (RIC-PBSCT) regimen is an alternative to conventional regimens with less immediate toxicity. Since immune recovery is of crucial importance for the control of infections, we retrospectively studied the recovery of T-, B- and NK cell subsets in 20 consecutive patients undergoing RIC-PBSCT. We also studied the thymic output using T-cell receptor excision circle assay. Engraftment was rapid and few infectious complications were seen: three early (before 2.5 months) cases of asymptomatic cytomegalovirus reactivation, two late Gram-negative bacterial infections and no fungal infection. While CD4+ T-cell reconstitution was slow, CD8+ T-cell counts were close to normal values at 4 months. Median CD19+ B-cell counts reached normal values at 11 months. Rapid CD56+ NK cell reconstitution was noticed as early as 1.5 months. Low T-cell receptor excision circle numbers and preponderance of memory-type subsets among T cells further suggested that CD8+ T-cell reconstitution resulted predominantly from peripheral expansion and that thymic-dependent reconstitution was severely impaired. In conclusion, large peripheral T-cell expansion may compensate for late thymic-dependent lymphopoiesis, and may, with other factors such as NK and B-cell reconstitution and careful antiinfectious prophylaxis, help limit the incidence of severe infections after RIC-PBSCT.

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Acknowledgements

We are indebted to all the clinical staff of the Bone Marrow Transplantation Unit of the Department of Hematology and the technical staff of the Immunology and Molecular Biology laboratories of the EFS Bourgogne/Franche-Comté for their help and their contribution to this work. This study was supported by grants from the associations ‘Cent pour Sang la Vie’ and ‘Moelle Partage et Vie’.

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Author notes

  1. C-E Bulabois & J-Y Cahn

    Present address: Department of Hematology, Centre Hospitalo-Universitaire, Grenoble, France

Authors and Affiliations

  1. Department of Hematology, Centre Hospitalo-Universitaire Jean Minjoz, Besançon Cedex, France

    F Larosa, E Deconinck, C-E Bulabois, P-S Rohrlich, K Ledu, P Helias & J-Y Cahn

  2. INSERM U645, Besançon Cedex, France

    F Larosa, C Marmier, E Robinet, C Ferrand, P Saas, E Deconinck, P-S Rohrlich, P Tiberghien & J-Y Cahn

  3. Université EA 2284, Besançon Cedex, France

    F Larosa, C Marmier, E Robinet, C Ferrand, P Saas, E Deconinck, P-S Rohrlich, P Tiberghien & J-Y Cahn

  4. EFS Bourgogne/Franche-Comté, Besançon Cedex, France

    F Larosa, C Marmier, E Robinet, C Ferrand, P Saas, E Deconinck, P-S Rohrlich, P Tiberghien & J-Y Cahn

  5. IFR 133 IBCT, Besançon Cedex, France

    F Larosa, C Marmier, E Robinet, C Ferrand, P Saas, E Deconinck, P-S Rohrlich, P Tiberghien & J-Y Cahn

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Correspondence to F Larosa.

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Larosa, F., Marmier, C., Robinet, E. et al. Peripheral T-cell expansion and low infection rate after reduced-intensity conditioning and allogeneic blood stem cell transplantation. Bone Marrow Transplant 35, 859–868 (2005). https://doi.org/10.1038/sj.bmt.1704889

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