Journal
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume 77, Issue 4, Pages 399-407Publisher
SPRINGER JAPAN KK
DOI: 10.1007/BF02982652
Keywords
immune reconstitution; cord blood transplantation; bone marrow transplantation; CD34(+) stem cell transplantation
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The present study compares immune reconstitution after allogeneic cord blood transplantation (CBT) and CD34(+) stem cell transplantation (CD34-SCT) with that after bone marrow transplantation (BMT). Eighty-eight children who underwent CBT (20 patients), BMT (58), and CD34-SCT (10) were enrolled, and lymphocytes and T-, B-, and natural killer-lymphocyte subsets were monitored for more than 5 years after transplantation. CBT recipients showed significant increases in (1) total lymphocyte counts (P < .001), (2) CD4(+)/CD8(+) cell ratios (P < .01), (3) CD4(+) and CD4(+)CD45RA(+) cells (P < .001), (4) CD8(+)CD11b(+) cells (P < .001), and (5) CD19(+) and CD19(+)CD5(+) cells (P < .0001) and marked decreases in the frequencies of CD8(+) and CD8(+)CD11b(-) cells (P < .0001). CD34-SCT recipients showed lower lymphocyte counts in the first 6 months and an emergence of lymphocyte and CD4(+)CD45RA(+) cells at approximately 9 months and I year. Both CBT and CD34-SCT recipients showed increased frequencies of CD56(+) cells at I month (CD34-SCT versus BMT, P < .001) but decreased frequencies after 6 months (CBT versus BMT, P < .001). Lymphoproliferative responses to exogenous interleukin 2 were constantly lower in CBT and CD34-SCT recipients than in BMT recipients. These results suggest that the delay in immune reconstitution after CBT in the early phase was mainly qualitative and related to the immaturity of cells, whereas the delay in CD34-SCT was mainly quantitative in the first several months. (C)2003 The Japanese Society of Hematology.
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