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Immune recovery after in vivo T‐cell depletion myeloablative conditioning hematopoietic stem cell transplantation in severe beta‐thalassemia children
Author(s) -
Qin Fang,
Shi Lingling,
Li Qiaochuan,
Zhang Zhongming,
Liu Lianjin,
Li Jing,
Yang Gaohui,
Lai YongRong
Publication year - 2019
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.13289
Subject(s) - hematopoietic stem cell transplantation , immune system , immunology , transplantation , bone marrow , medicine , stem cell , haematopoiesis , cord blood , thalassemia , t cell , biology , genetics
Background The clinical outcome of hematopoietic stem cell transplantation (HSCT) in those with severe beta‐thalassemia (β‐TM) is closely related to post‐transplantation immune reconstitution (IR). However, the data on the IR in these settings are scarce. Methods A prospective analysis of the clinical outcome and IR in 47 children with severe β‐TM who underwent in vivo T‐cell depletion myeloablative conditioning and matched sibling donor HSCT was performed. Immune reconstitution, including immune cell subset counts, as well as the generation of new T and B cells assays after HSCT, was measured. Results In the first year after HSCT, bacterial infections and cytomegalovirus (CMV) reactivation were observed in 70.2% and 36.2% of the patients, respectively. In the same period, poor CD4 + T‐cell recovery was observed. The B cells recovered within 6 months. Natural killer (NK) cells recovered as early as 1 month, but their function was defective. Cord blood and bone marrow (CB + BM) group had slower T‐cell recovery, and higher B cells and NK cells in comparison with peripheral blood and bone marrow (PB + BM) group. Conclusions The high incidence of infection within 1 year after in vivo T‐cell depletion myeloablative conditioning HSCT in severe β‐TM was consistent with poor IR.