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Post-Transplant Events

T cell regeneration in pediatric allogeneic stem cell transplantation

Bone Marrow Transplantation volume 39, pages 149–156 (2007)Cite this article

Abstract

Delayed and/or insufficient T cell recovery post hematopoietic stem cell transplantation (HSCT) leads to an increased risk of morbidity and mortality. We evaluated thymic function and its association with T cell regeneration post HSCT and identified factors involved in the process among pediatric stem cell transplant recipients. T cell regeneration in 66 pediatric patients was prospectively followed by naive T cell phenotyping, measuring of T cell receptor excision circles (TRECs) and expression of Foxp3 by regulatory T cells for the first 18 months post HSCT. TRECs were lower pre-HSCT in children with a malignant than non-malignant primary disease or immunosuppressed controls (P=0.001). Naive T lymphocyte reconstitution and thymic recovery were slow in the recipients of allogeneic stem cell grafts post HSCT. Infections caused by herpesviruses had a prognostic impact on mortality. Children with low TRECs had a high mortality (P=0.05) and low TRECs were also associated with extensive chronic graft-versus-host disease from 6 months onwards. Low amount of Foxp3 pre-HSCT was associated with an increased mortality post HSCT (P=0.03). Our study indicates an association between impaired T cell regeneration and thymic dysfunction and the clinical post transplant complications in pediatric allogeneic stem cell transplantation.

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Acknowledgements

We thank Inna Sareneva and Noora Alakulppi MSc for technical assistance. This study was supported by the Nona and Kullervo Väre Foundation and the Finnish Cultural Foundation and the Sigrid Juselius Foundation.

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Author notes

  1. H Olkinuora and K Talvensaari: These authors contributed equally to this work.

Authors and Affiliations

  1. Division of Hematology-Oncology and Stem Cell Transplantation, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland

    H Olkinuora, U Saarinen-Pihkala & K Vettenranta

  2. Finnish Red Cross Blood Transfusion Service, Helsinki, Finland

    K Talvensaari, T Kaartinen & J Partanen

  3. Laboratory Diagnostics, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland

    S Siitonen

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  1. H Olkinuora
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  2. K Talvensaari
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  5. U Saarinen-Pihkala
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Correspondence to H Olkinuora.

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Olkinuora, H., Talvensaari, K., Kaartinen, T. et al. T cell regeneration in pediatric allogeneic stem cell transplantation. Bone Marrow Transplant 39, 149–156 (2007). https://doi.org/10.1038/sj.bmt.1705557

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  • DOI: https://doi.org/10.1038/sj.bmt.1705557

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