Frequent viral infections and delayed CD4(+) cell recovery following CD34(+) cell-selected autologous peripheral blood stem cell transplantation

This study compares the reconstitution of T-lymphocyte subsets and the inci dence of infections following CD34(+) cell-selected autologous peripheral b lood stem cell transplantation (PBSCT) (n = 15) and unselected auto-PBSCT ( n = 16). In the CD34(+) cell-selected auto-PBSCT group, the mean count of C D4(+) cells had significantly decreased at 30 days after transplantation co mpared with pretransplantation, and did not reach the safe minimum level of 0.2 x 10(9)/1 even at 90 days after transplantation. Compared with unselec ted auto-PBSCT, CD4(+) cell reconstitution after CD34(+) cell-selected auto -PBSCT was significantly delayed within the first 90 days after transplanta tion. Cytomegalovirus infections developed more frequently after CD34(+) ce ll-selected auto-PBSCT than after unselected auto-PBSCT (nine patients vs, two patients, P = 0.0057). Hemorrhagic cystitis due to adenovirus type 11 i nfections developed in three patients who underwent CD34(+) cell-selected a uto-PBSCT Positive correlation between the counts of reinfused CD34(+) cell s and the counts of CD4(+) cells were found at 90 days after CD34(+) cell-s elected auto-PBSCT. No significant difference was found in the frequency of viral infections, however, between patients transplanted with >2 x 10(6)/k g of CD34(+) cells and those transplanted with <2 x 10(6)/kg of CD34(+) cel ls. Careful monitoring for viral infection is necessary after CD34(+) cell- selected auto-PBSCT. (C) 1999 The Japanese Society of Hematology.