Open AccessLymphocyte reconstitution after allogeneic blood stem cell transplantation for hematologic malignancies
Author(s) -
Ž Pavletić,
Shantaram S. Joshi,
Samuel J. Pirruccello,
Stefano Tarantolo,
J Kollath,
Elizabeth Reed,
Philip J. Bierman,
Julie M. Vose,
Phyllis I. Warkentin,
Thomas G. Gross,
K. Nasrati,
Jamés O. Armitage,
Anne Kessinger,
Michael Bishop
Publication year - 1998
Publication title -
bone marrow transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 127
eISSN - 1476-5365
pISSN - 0268-3369
DOI - 10.1038/sj.bmt.1701037
Subject(s) - medicine , lymphocyte , cd8 , transplantation , methotrexate , immunology , donor lymphocyte infusion , stem cell , natural killer cell , gastroenterology , graft versus host disease , cytotoxicity , immune system , biology , biochemistry , in vitro , genetics
Forty-one patients were studied at set times after allogeneic blood stem cell transplantation (alloBSCT) for recovery of lymphocyte numbers and function. Cells were mobilized with G-CSF from HLA-matched related donors and cryopreserved. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate; G-CSF was administered post-transplant. Median time to absolute lymphocyte count (ALC) >500/microl was 17 days vs 41 and 49 days in historical alloBMT patients with G-CSF (n = 23) or no cytokine (n = 29) post-transplant, respectively (P < 0.0001). CD4/CD8+ ratio was 1.9 on day 28 after alloBSCT, then gradually declined to 0.8 at 1 year due to more rapid CD8+ cell recovery. Mean phytohemagglutinin-induced T cell responses were lower than normal on day +28 (P < 0.05), then tended to recover towards normal values. Natural-killer cytotoxicity remained low from day +28 to 1 year post-alloBSCT, but considerable lymphokine-activated killer cytotoxicity was induced from cells already obtained on day +28. Faster lymphocyte recovery correlated with better survival in alloBSCT patients (median follow-up 287 days, P = 0.002), ALC recovery was not affected by acute GVHD, CMV infections or doses of infused cells. ALC recovery did not correlate with survival in either historical alloBMT group. These data suggest that after alloBSCT lymphocyte reconstitution is faster than after alloBMT, and that quicker lymphocyte recovery predicts better survival in the alloBSCT setting.