A prospective comparison of immune reconstitution in pediatric recipients of positively selected CD34+ peripheral blood stem cells from unrelated donors vs recipients of unmanipulated bone marrow from related donors

Bone Marrow Transplant. 2003 Aug;32(4):379-90. doi: 10.1038/sj.bmt.1704158.

Abstract

Positively selected CD34(+) hematopoietic stem cells from unrelated donors (UD-HSCT) have been successfully transplanted, but little is known about immune reconstitution in this setting. Here we report a prospective comparison of immune reconstitution in recipients of UD-HSCT and of unmanipulated bone marrow from matched sibling donors (MSD-BMT). T-cell reconstitution occurred more than 100 days later in the UD-HSCT than in the MSD-BMT group. The first T cells after UD-HSCT were almost exclusively CD45RO(+) HLA-DR(+), whereas early-emerging T cells after MSD-BMT more frequently expressed CD62L, CD28, and CD25. In both groups, numbers of CD45RA(+) naive T cells increased after 180 days. After UD-HSCT, the T-cell-receptor (TCR)-repertoire was severely skewed and showed significantly reduced diversity during the first year, but only minor abnormalities were seen after MSD-BMT. TCR-diversity increased simultaneously with the number of naive T cells. In both groups, we observed transient expansions of gammadelta T cells. B cells were reconstituted more rapidly in UD-HSCT than in MSD-BMT recipients, whereas the rapidity of NK-cell reconstitution was similar in the two groups. In summary, T-cell reconstitution was slower after UD-HSCT than after MSD-BMT because of the delayed recovery of early memory-type T cells with reduced TCR-diversity, whereas naive T-, NK-, and B cells were reconstituted similarly in the two groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antigens, CD34 / biosynthesis
  • B-Lymphocytes / metabolism
  • Bone Marrow Cells / pathology
  • CD28 Antigens / biosynthesis
  • CD3 Complex / biosynthesis
  • Cell Division
  • Child
  • Child, Preschool
  • Female
  • Flow Cytometry
  • HLA-DR Antigens / biosynthesis
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Immunoglobulin A / chemistry
  • Immunoglobulin G / chemistry
  • Immunoglobulin M / chemistry
  • Immunologic Memory
  • Infant
  • Killer Cells, Natural / metabolism
  • L-Selectin / biosynthesis
  • Leukocyte Common Antigens / biosynthesis
  • Male
  • Phenotype
  • Prospective Studies
  • Receptors, Antigen, T-Cell / metabolism
  • Receptors, Interleukin-2 / biosynthesis
  • Stem Cells / metabolism*
  • T-Lymphocytes / metabolism
  • Time Factors
  • Tissue Donors
  • Transplantation Immunology*
  • Transplantation, Homologous

Substances

  • Antigens, CD34
  • CD28 Antigens
  • CD3 Complex
  • HLA-DR Antigens
  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M
  • Receptors, Antigen, T-Cell
  • Receptors, Interleukin-2
  • L-Selectin
  • Leukocyte Common Antigens