L. Laurenti et al., Long-term immune recovery after CD34(+) immunoselected and unselected peripheral blood progenitor cell transplantation: a case-control study, HAEMATOLOG, 84(12), 1999, pp. 1100-1103
Background and Objectives. CD34(+) stem cell selection induces extensive T-
cell depletion as a consequence of ex vivo manipulation. The impact of T-ce
ll depletion on long-term immunologic recovery after autologous CD34(+) per
ipheral blood progenitor cell transplantation (CD34(+) PBPCT) is not well c
haracterized. We compared the long term immunologic recovery in two groups
of patients submitted to CD34(+) PBPCT or unselected autologous peripheral
blood progenitor cell transplantation (uPBPCT),
Design and Methods, Eight patients in both groups were closely matched for
diagnosis, age, disease status at transplantation and conditioning regimen
and lymphocyte phenotype was prospectively evaluated during long-term post-
transplantation follow-up.
Results. At a median of 18 months after transplantation, CD3(+) lymphocyte
subset remained below the normal range in both groups. CD19(+) B lymphocyte
s subset after CD34(+) PBPCT was within the normal range In both groups, CD
4(+) lymphocytes were depressed while the CD8(+) lymphocyte subset was incr
eased in group A and in the normal range in group B, As a result, inversion
of CD4/CD8 ratio was documented in both groups. T-activated lymphocytes (C
D3DR(+)) and natural killer (CD16/56(+)) cells were increased In both group
s,
Interpretation and Conclusions, Long-term immune recovery appears to be una
ffected by extensive ex vivo manipulation in this adult population when com
pared to recovery after unmanipulated PBPCT, CD34(+) selection, although ca
uses an extensive depletion of T lymphocytes in the graft does not represen
t a risk factor for delayed CD4(+) recovery late after transplantation. Ele
vated numbers of Nh cells and activated T-cells, which have antineoplastic
activity, are maintained late after autologous CD34(+) transplantation, (C)
1999, Ferrata Storti Foundation.