Immune Reconstitution After Allogenic Stem Cell Transplantation: An Observational Study in Pediatric Patients

Overview

Journal Hematol Transfus Cell Ther

Specialty Hematology

Date 2022 Jul 16

PMID 35842310

Authors

Aline Risson Belinovski

Polliany Dorini Pelegrina

Alberto Cardoso Martins Lima

Cilmara Cristina Kuwahara Dumke

Adriana Mello Rodrigues

Gisele Loth

Fernanda Moreira de Lara Benini

Ana Luiza Melo Rodrigues

Fabio Araujo Motta

Carolina Prando

Carmem Bonfim

Affiliations

Soon will be listed here.

Abstract

Introduction: The immune reconstitution (IR) after the allogenic hematopoietic stem cell transplantation (allo-HSCT) is a progressive process intrinsically correlated to the therapeutic success. It is essential to understand the interfering factors in IR to prevent the HSCT-related mortality.

Methods: We retrospectively evaluated the clinical outcomes, absolute lymphocyte counts (ALCs) and lymphocyte subtypes at different time-points of 111 pediatric patients with allogeneic HSCT for malignant and non-malignant diseases from 2013 to 2018.

Results: The ALCs gradually increased on D+30, D+100, and D+180 (medians 634/μL, 1022/μL and 1541/μL, respectively). On D+100, the CD3+CD8+ achieved the highest recovery rate (68%), followed by the CD16+CD56+ (47%), CD3+CD4+ (39%) and CD19+ (8%). The adequate ALC recovery was associated with age < 8 years, bone marrow grafts, myeloablative conditioning, non-use of serotherapy and non-haploidentical donors. The ALC and CD3+CD8+ on D+100 counts were higher in patients with the cytomegalovirus infection. The CD3+CD4+ recovery was associated with an age < 8 years, a non-malignant disease and a lower incidence of acute graft-versus-host disease ≥ grade 2. Furthermore, the ALC recovery on D+100 resulted in a higher overall survival, regardless of the disease type (HR 3.65, 1.05 - 12.71, p = 0.04).

Conclusion: Several factors influenced the IR after the allo-HSCT. The ALC ≥ 500/μL on D+100 was a simple IR predictor of survival, easily available to resource-limited centers.

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