Lymphocyte subset reconstitution after unrelated cord blood or bone marrow transplantation in children

Br J Haematol. 2011 Feb;152(3):322-30. doi: 10.1111/j.1365-2141.2010.08409.x. Epub 2010 Dec 7.

Abstract

We report the post-transplant lymphocyte subset recovery of 226 children treated with Unrelated Cord Blood transplant (UCBT) (n = 112) or Unrelated Bone Marrow Transplant (UBMT) (n = 114) for malignant or non-malignant diseases. Absolute numbers of natural killer (NK), B and T cells were monitored by flow cytometry up to 5 years post-transplant. Immunological endpoints were: time to achieve a CD3(+) cell count > 0·5 and 1·5 × 10⁹/l, CD4(+) > 0·2 and 0·5 × 10⁹/l, CD8(+) > 0·25 ×10⁹/l, CD19(+) > 0·2 × 10⁹/l, NK > 0·1 × 10⁹/l. These endpoints were analysed through the use of cumulative incidence curves in the context of competing risks. CD8(+) T cell recovery was delayed after UCBT with a median time to reach CD8(+) T cells > 0·25 × 10⁹/l of 7·7 months whereas it was 2·8 months in UBMT (P < 0·001). B cell recovery was better in UCBT, with a median time to reach CD19(+) cells > 0·2 × 10⁹/l of 3·2 months in UCBT and 6·4 months in UBMT (P = 0·03). Median time for CD4(+) T cell and NK cell recovery was similar in UCBT and UBMT. CD4(+) T cells recovery was negatively correlated to age (better reconstitution in younger patients, P = 0·002). CD8(+) T cells recovery was shorter in recipients with a positive cytomegalovirus serology (P =0·001).

MeSH terms

  • Adolescent
  • B-Lymphocytes / immunology
  • Bone Marrow Transplantation / methods*
  • Child
  • Child, Preschool
  • Cord Blood Stem Cell Transplantation / methods*
  • Female
  • Hematologic Diseases / immunology
  • Hematologic Diseases / therapy*
  • Humans
  • Infant
  • Killer Cells, Natural / immunology
  • Lymphocyte Count
  • Lymphocyte Subsets / immunology*
  • Male
  • Opportunistic Infections / immunology
  • T-Lymphocyte Subsets / immunology
  • Treatment Outcome