1. ¹Department of Hematology/Oncology, University of Freiburg, Freiburg, Germany
2. ²Department of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
3. ³Department of Hematology/Oncology, Klinikum Offenburg, Offenburg, Germany

Correspondence: Professor Dr J Finke, Department of Hematology/Oncology, University of Freiburg, Hugstetterstrasse 55, Freiburg 79106, Germany. E-mail: juergen.finke@uniklinik-freiburg.de

⁴Current address: Department of Hematology/Oncology, Augusta Hospital, Bochum, Germany.

Received 13 July 2006; Revised 21 November 2006; Accepted 27 December 2006; Published online 26 March 2007.

Abstract

Here we investigated the influence of parameters known before hematopoietic stem cell transplantation (HSCT) as well as the relevance of graft-versus-host disease (GvHD) and cytomegalovirus (CMV) reactivation on post transplant lymphocyte reconstitution in 148 patients treated in our institution between 1996 and 2003. Median patient age was 42 (19–68) years, HSCT followed standard high dose (n=91) or reduced-intensity conditioning regimens (n=57) with bone marrow (BM, n=67) or peripheral blood stem cells (PBSC, n=81) from related (n=71) or unrelated (n=77) donors. In the first months, we observed a partially faster reconstitution of CD3⁺4⁺, CD3⁺8⁺ and CD4⁺45RA⁺ T cells in patients following peripheral blood stem cell transplantation when compared to bone marrow transplantation. Prolonged CD3⁺4⁺ and CD4⁺45RA⁺ lymphopenia was noted after unrelated donor HSCT and GvHD prophylaxis containing anti-T-lymphocyte globulin. Lymphocyte subset counts in patients older than the median age were comparable to those in patients transplanted at a younger age and not influenced by the conditioning regimen. CD3⁺8⁺ T cell reconstitution was strongly correlated with CMV reactivation, but not significantly affected by CMV serostatus before HSCT. Incidence or extent of GvHD did not significantly influence lymphocyte reconstitution. Therefore, the source of graft is the most predictive parameter in early lymphocyte reconstitution, but the differences in lymphocyte recovery completely resolved within the first year after HSCT.