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Immune reconstitution after transplantation of autologous peripheral CD34 + cells: analysis of predictive factors and comparison with unselected progenitor transplants
Author(s) -
Rutella Sergio,
Rumi Carlo,
Laurenti Luca,
Pierelli Luca,
Sora' Federica,
Sica Simona,
Leone Giuseppe
Publication year - 2000
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2000.01824.x
Subject(s) - cd19 , cd8 , cd34 , progenitor cell , lymphocyte , immunology , medicine , transplantation , cd3 , andrology , granulocyte colony stimulating factor , stem cell , immune system , biology , chemotherapy , genetics
The recovery of lymphocyte count, CD4 + and CD8 + T‐cell subsets, natural killer (NK) cells and CD19 + B‐cells was evaluated in a cohort of 15 patients receiving autologous CD34 + peripheral blood progenitor cells (PBPCs; group A) for haematological malignancies and in 20 patients transplanted with autologous unselected PBPCs (group B). Lymphocyte count recovered in both patient cohorts, being significantly lower in group A than in group B 1 ( P = 0·008) and 2 months ( P = 0·0035) after progenitor cell infusion. The repopulation of CD3 + T‐cells occurred more rapidly in group B than in group A ( P = 0·034 on week 4); CD19 + B‐lymphocytes did not return to reference ranges in either group of patients. The count of CD4 + T‐lymphocytes remained < 200/μl during the study period in patients transplanted with CD34 + PBPCs, significantly lower than group B levels ( P = 0·034 and P = 0·021 on weeks 4 and 8 respectively). CD8 + T‐cells increased rapidly in both groups; thus, the CD4 to CD8 ratio was severely reduced. CD4 + and CD8 + T‐cells displayed an activated phenotype in both groups of patients, co‐expressing the HLA‐DR antigen throughout the study period. NK cells followed a similar repopulation kinetics in both study groups, although their expansion was greater in group B than in group A ( P = 0·014 on week 4). In the CD34 + group, post‐transplant administration of granulocyte colony‐stimulating factor predicted a faster lymphocyte recovery in multivariate analysis ( P = 0·025); interestingly, the amount of passively transferred lymphocytes correlated inversely with time to achieve a lymphocyte count > 0·5 × 10 9 /l ( r = –0·63, P = 0·01). Further investigations are necessary to characterize T‐cell competence after transplantation of CD34 + PBPCs.