Summary:
In this retrospective study, we review the immune reconstitution of children undergoing autologous hematopoietic stem cell transplantation. A total of 125 patients underwent autologous transplantation between 1992 and 2000. The report includes data on 58 patients. Data were not available on the remaining patients who either died before testing or data were not obtained. The parameters evaluated include: (a) immunophenotype by flow cytometry to quantify lymphocyte subpopulations (b) mitogen stimulation assays, and (c) quantitative immunoglobulins. The analysis reveals that CD3+ cells did not reach the normal range during the first year post-transplant. The median percentage of CD4+ cells was below normal up to 6 months post-transplant, while the absolute number remain low throughout the first year. The CD8+ percentage and absolute numbers remain normal at all times post-transplant. The CD19+ cells were also normal post-transplantation. The mitogen lymphocyte stimulation was normal in 27 out of 31 patients tested after 6 months post-transplant. Our analysis of immune reconstitution shows a similar pattern to previous studies with a faster recovery of the CD4/CD8 ratio, especially in those patients who did not receive TBI. In conclusion, the observed deficiencies are transient and have very little clinical significance because, historically, the rate of serious infections is low despite prolonged immune suppression. The recovery postautologous transplant is fast.
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References
Lum LG . The kinetics of immune reconstitution after human marrow transplantation. Blood 1987; 69: 369–380.
Guillaume T, Rubinstein DB, Symann M . Immune reconstitution and immunotherapy after autologous hematopoietic stem cell transplant. Blood 1998; 92: 1471–1490.
Roberts MM, To LB, Gillis D et al. Immune reconstitution following peripheral blood stem cell transplantation, autologous bone marrow transplantation and allogeneic bone marrow transplantation. Bone Marrow Transplant 1993; 12: 469–475.
Parra C, Roldan E, Rodriguez C et al. Reconstitution of peripheral blood lymphocytes in patients treated with bone marrow transplantation: comparison between allogeneic and autologous transplantation. Med Clin (Barc) 1999; 113: 1–5.
Kiesel S, Pezzutto A, Körbling M et al. Autologous peripheral stem cell transplantation: analysis of autografted cells and lymphocyte recovery. Transplant Proc 1989; 21: 3084–3088.
San Miguel JF, Hernandez MD, Gonzales M et al. A randomized study comparing the effect of GM-CSF and G-CSF on immune reconstitution after autologous bone marrow transplantation. Br J Haemotol 1996; 94: 140–147.
Mackall CL, Stein D, Fleisher TA et al. Prolonged CD4 depletion after sequential autologous peripheral blood progenitor cell infusions in children and young adults. Blood 2000; 96: 754–762.
Kamani N, Kattamis A, Carroll A et al. Immune reconstitution after autologous purged bone marrow transplantation in children. J Pediatr Hematol Oncol 2000; 22: 13–19.
Takaue Y, Okamoto Y, Kawano Y et al. Regeneration of immunity and varicella-zoster virus infection after high-dose chemotherapy and peripheral blood stem cell autografts in children. Bone Marrow Transplant 1994; 14: 219–223.
Figuerres E, Haut PR, Olzewski M, Kletzel M . Analysis of parameters affecting engraftment in children undergoing autologous peripheral blood stem cell transplants. Bone Marrow Transplant 2000; 25: 583–588.
Kletzel M, Haut PR, Olzewski M, Figuerres E . Analysis of parameters engraftment in children undergoing allogeneic BM transplants. Cytotherapy 1999; 1: 417–422.
Siena S, Castro-Malaspina H, Gulati SC et al. Effects of in vitro purging with 4-hydroperoxycyclophosphamide on the hematopoietic and microenvironmental elements of human bone marrow. Blood 1985; 65: 655–662.
Kemshead JT . Immunomagnetic manipulation of hematopoietic cells: a review of current technology. J Hematotherapy 1992; 1: 35–44.
Mackall CL . T-cell immunodeficiency following cytotoxic antineoplastic therapy: a review. Oncologist 1999; 4: 370–378.
Gershwin ME, Goetzl EJ, Steinberg AD . Cyclophosphamide: use in practice. Ann Intern Med 1974; 80: 531–540.
Samlowski W, Johnson H, Hammond E et al. Marrow ablative doses of gamma-irradiation and protracted changes in peripheral lymph node microvasculature of murine and human bone marrow recipients. Lab Invest 1987; 56: 85–95.
Koehne G, Zeller W, Stockschlaeder M, Zander AR . Phenotype of lymphocyte subsets after autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 1997; 19: 149–156.
Olsen GA, Gockermann JP, Bast RC et al. Altered immunologic reconstitution after standard-dose chemotherapy or high-dose chemotherapy with autologous bone marrow support. Transplant 1988; 46: 57–60.
Henon PR, Liang H, Beck-Wirth G et al. Comparison of hematopoietic and immune recovery after autologous bone marrow or blood stem cell transplants. Bone Marrow Transplant 1992; 9: 285–291.
Ashihara E, Shimazaki C, Yamagata N et al. Reconstitution of lymphocyte subsets after peripheral blood stem cell transplantation: two-color flow cytometric analysis. Bone Marrow Transplant 1994; 13: 377–381.
Rutella S, Rumi C, Laurenti L et al. Immune reconstitution after transplantation of autologous peripheral CD34+ cells: analysis of predictive factors and comparison with unselected progenitor transplants. Br J Haematol 2000; 108: 105–115.
Shenoy S, Mohanakumar T, Todd G et al. Immune reconstitution following allogeneic peripheral blood stem cell transplants. Bone Marrow Transplant 1999; 23: 335–346.
Talmadge J, Reed E, Ino K et al. Rapid immunologic reconstitution following transplantation with mobilized peripheral blood stem cells as compared to bone marrow. Bone Marrow Transplant 1997; 19: 161–172.
Charbonnier A, Sainty D, Faucher C et al. Immune reconstitution after blood cell transplantation. Hematol Cell Ther 1997; 39: 261–264.
Armitage RJ, Goldstone AH, Richards JDM, Cawley JC . Lymphocyte function after autologous bone marrow transplantation (BMT): a comparison with patients treated with allogeneic BMT and with chemotherapy only. Br J Hematol 1986; 63: 637–647.
Bengtsson M, Totterman TH, Smedmyr B et al. Regeneration of functional and activated NK and T sub-subset cells in the marrow and blood after autologous bone marrow transplantation: a prospective phenotypic study with 2/3-color FACS analysis. Leukemia 1989; 3: 68–75.
Mackall CL, Fleisher TA, Brown MR et al. Distinctions between CD8+ and CD4+ T-cell regenerative pathways result in prolonged T-cell subset imbalance after intensive chemotherapy. Blood 1997; 89: 3700–3707.
Scheid C, Pettengell R, Ghielmini M et al. Time-course of the recovery of cellular immune function after high-dose chemotherapy and peripheral blood progenitor cell transplantation for high-grade non-Hodgkin's lymphoma. Bone Marrow Transplant 1995; 15: 901–906.
Ho AD, Maruyama M, Maghazachi A et al. Soluble CD4, soluble CD8 soluble CD25, lymphopoieitic, recovery and endogenous cytokines after high-dose chemotherapy and blood stem cell transplantation. Blood 1994; 84: 3550–3557.
Foot AB, Potter MN, Donaldson C et al. Immune reconstitution after BMT in children. Bone Marrow Transplant 1993; 11: 7–13.
Leino L, Lilius EM, Nikoskelainen J et al. The reappearance of 10 differentiation antigens on peripheral blood lymphocytes after allogeneic bone marrow transplantation. Bone Marrow Transplant 1991; 8: 339–344.
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Hoepfner, S., Haut, P., O'Gorman, M. et al. Rapid immune reconstitution following autologous hematopoietic stem cell transplantation in children: a single institution experience. Bone Marrow Transplant 31, 285–290 (2003). https://doi.org/10.1038/sj.bmt.1703831
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DOI: https://doi.org/10.1038/sj.bmt.1703831
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