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Immune reconstitution after purified autologous and allogeneic blood stem cell transplantation compared with unmanipulated bone marrow transplantation in children
Author(s) -
Schwinger Wolfgang,
WeberMzell Daniela,
Zois Birgit,
Rojacher Tanja,
Benesch Martin,
Lackner Herwig,
Dornbusch Hans Juergen,
Sovinz Petra,
Moser Andrea,
Lanzer Gerhard,
Schauenstein Konrad,
Ofner Petra,
Handgretinger Rupert,
Urban Christian
Publication year - 2006
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 - 10.1111/j.1365-2141.2006.06244.x
Subject(s) - transplantation , haematopoiesis , stem cell , medicine , bone marrow , cd34 , immune system , immunology , hematopoietic stem cell transplantation , peripheral blood stem cells , gastroenterology , biology , genetics
Summary Immune reconstitution is critical for the long‐term success of haematopoietic stem cell transplantation (HSCT). We prospectively analysed immune reconstitution parameters after transplantation of autologous (group 1; n = 10) and allogeneic (group 2; n = 12) highly purified CD34 + peripheral blood stem cells (PBSC) and unmanipulated allogeneic bone marrow (BM) (group 3; n = 9) in children. Median follow‐up after HSCT was 56 (group 1), 61 (group 2), and 40·5 months (group 3). Median CD34‐cell dose transplanted in the three groups was 9·4 × 10 6 /kg, 20·3 × 10 6 /kg, and 4·25 × 10 6 /kg recipient's body weight (BW) respectively. Complete haematopoietic engraftment was seen in all patients without any significant differences between the three groups. T‐cell reconstitution at 6 months was significantly delayed in autologous peripheral blood stem cell transplantation (PBSCT) compared with allogeneic BM transplantation ( P < 0·028) and allogeneic PBSCT ( P < 0·034). At 3 months after transplantation numbers of CD56 + /3 − natural killer cells were higher in the allogeneic PBSC group ( P < 0·01) compared with the BM group. The numbers of proven bacterial and viral infections were equally distributed between the three groups. In conclusion, recipients of allogeneic highly purified CD34 + PBSC or unmanipulated BM have higher lymphocyte subset counts at 6 months after transplantation than recipients of autologous CD34‐selected PBSC. Infection rates and outcome, however, were not significantly different.