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. 2018 Apr 24;2(8):909-922.
doi: 10.1182/bloodadvances.2017014464.

Delayed immune reconstitution after allogeneic transplantation increases the risks of mortality and chronic GVHD (V体育2025版)

Nelli Bejanyan  1 , Claudio G Brunstein  1 , Qing Cao  2 , Aleksandr Lazaryan  1 , Xianghua Luo  2 , Julie Curtsinger  3 , Rohtesh S Mehta  1 , Erica Warlick  1 , Sarah A Cooley  1 , Bruce R Blazar  3 , Jeffrey S Miller  1 , Daniel Weisdorf  1 , John E Wagner  3 , Michael R Verneris  3
Affiliations

Delayed immune reconstitution after allogeneic transplantation increases the risks of mortality and chronic GVHD (V体育2025版)

Nelli Bejanyan (V体育安卓版) et al. Blood Adv. .

Abstract

Slow immune reconstitution is a major obstacle to the successful use of allogeneic hematopoietic cell transplantation (allo-HCT). As matched sibling donor (MSD) allo-HCT is regarded as the gold standard, we evaluated the pace of immune reconstitution in 157 adult recipients of reduced-intensity conditioning followed by MSD peripheral blood HCT (n = 68) and compared these to recipients of umbilical cord blood (UCB; n = 89). At day 28, UCB recipients had fewer natural killer (NK) cells than MSD recipients, but thereafter, NK cell numbers (and their subsets) were higher in UCB recipients. During the first 6 months to 1 year after transplant, UCB recipients had slower T-cell subset recovery, with lower numbers of CD3+, CD8+, CD8+ naive, CD4+ naive, CD4+ effector memory T, regulatory T, and CD3+CD56+ T cells than MSD recipients. Notably, B-cell numbers were higher in UCB recipients from day 60 to 1 year. Bacterial and viral infections were more frequent in UCB recipients, yet donor type had no influence on treatment-related mortality or survival. Considering all patients at day 28, lower numbers of total CD4+ T cells and naive CD4+ T cells were significantly associated with increased infection risk, treatment-related mortality, and chronic graft-versus-host disease (GVHD) VSports手机版. Patients with these characteristics may benefit from enhanced or prolonged infection surveillance and prophylaxis as well as immune reconstitution-accelerating strategies. .

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Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Immune reconstitution after MSD vs UCB RIC allogeneic transplant. (A) Absolute lymphocyte count; (B) total NK cells (CD3−CD56+); (C) total CD3+ T cells; (D) total CD8+ T cells; (E) total CD4+ T cells; (F) naïve CD4+ T cells (CD45RA+CD27+); (G) T regulatory cells (CD4+CD25bright CD127); and (H) B cells. The boxes show the interquartile range of absolute cell count (/μL) for each immune cell type. The bold horizontal lines inside the boxes indicate the median absolute cell count (/μL); the whiskers represent 1.5× the height of the box (or minimum/maximum values if there is no value in that range); and the circles indicate the outliers.
Figure 1.
Figure 1.
Immune reconstitution after MSD vs UCB RIC allogeneic transplant. (A) Absolute lymphocyte count; (B) total NK cells (CD3−CD56+); (C) total CD3+ T cells; (D) total CD8+ T cells; (E) total CD4+ T cells; (F) naïve CD4+ T cells (CD45RA+CD27+); (G) T regulatory cells (CD4+CD25bright CD127); and (H) B cells. The boxes show the interquartile range of absolute cell count (/μL) for each immune cell type. The bold horizontal lines inside the boxes indicate the median absolute cell count (/μL); the whiskers represent 1.5× the height of the box (or minimum/maximum values if there is no value in that range); and the circles indicate the outliers.
Figure 2.
Figure 2.
Infection density. (A) Infection density by donor type and post-HCT time period. (B) Infection density at days 29 to 365 by lower and higher absolute cell counts.
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References

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