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Differences in Aspergillus‐ specific immune recovery between T‐cell‐replete and T‐cell‐depleted hematopoietic transplants
Author(s) -
Perruccio Katia,
Topini Fabiana,
Tosti Antonella,
Gazzola Maria Vittoria,
Messina Chiara,
Martelli Massimo F.,
Caniglia Maurizio,
Velardi Andrea,
Cesaro Simone
Publication year - 2015
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12531
Subject(s) - t cell , immune system , immunosuppression , transplantation , aspergillosis , immunology , hematopoietic stem cell transplantation , hematopoietic cell , biology , cell , medicine , stem cell , haematopoiesis , genetics
Background After hematopoietic stem cell transplantation, invasive aspergillosis remains one of the most lethal infections. Susceptibility may be due to prophylaxis and treatment of graft‐vs.‐host disease in T‐cell‐replete transplants, and delayed immune rebuilding due to T‐cell depletion in haploidentical transplantation. Methods We monitored CD 4 + T‐cell recovery and anti‐ Aspergillus immune competence in pediatric recipients of T‐cell‐replete matched transplants and of prevalently adult recipients of T‐cell‐depleted matched or haploidentical transplants for hematological malignancies. Results Although CD 4 + T‐cell counts were higher in T‐cell‐replete transplant recipients at all post‐transplant time points, Aspergillus ‐specific T cells were first detected 15–18 months after T‐cell‐replete matched, 7–9 months after T‐cell‐depleted matched, and 9–12 months after haploidentical transplantation, respectively. Incidence of invasive aspergillosis was 22% with 10% mortality after T‐cell‐replete transplants, 0% after T‐cell‐depleted matched, and 7% with 4% mortality after haploidentical transplants. Conclusions Although T‐cell counts were significantly higher after T‐cell‐replete transplants, post‐transplant immune suppression/Gv HD appeared to impair their function. Specific Aspergillus immune competence recovered faster after T‐cell‐depleted transplants, whether matched or haploidentical. T‐cell‐replete transplants were associated with a higher incidence of invasive aspergillosis and Aspergillus ‐related deaths. These results showed that T‐cell depletion without post‐transplant immunosuppression is associated to a faster immune recovery than T‐cell‐replete transplantation.