Immune reconstitution after combined haploidentical and umbilical cord blood transplant

Leuk Lymphoma. 2013 Jun;54(6):1242-9. doi: 10.3109/10428194.2012.739688. Epub 2013 Mar 1.

Abstract

Umbilical cord blood (UCB) stem cells are frequently employed for allogeneic stem cell transplant, but delayed myeloid and lymphoid immune reconstitution leads to increased risk of infections. We recently reported the clinical results of 45 patients enrolled on a pilot study combining UCB with a human leukocyte antigen (HLA)-haploidentical donor with reduced-intensity conditioning who showed rapid neutrophil and platelet recovery. We report here preliminary immune reconstitution data of these patients. Patients were assessed for lymphocyte subsets, T-cell diversity, Cylex ImmuKnow assay and serological response to pneumococcal vaccination. Natural killer (NK)-cell and B-cell reconstitution were rapid at 1 month and 3 months, respectively. T-cell recovery was delayed, with a gradual increase in the number of T-cells starting around 6 months post-transplant, and was characterized by a diverse polyclonal T-cell repertoire. Overall, immune reconstitution after haplo-cord transplant is similar to that seen after cord blood transplant, despite infusion of much lower cord blood cell dose.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cord Blood Stem Cell Transplantation* / adverse effects
  • Female
  • Graft Survival
  • Haplotypes*
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / therapy
  • Hematopoiesis / immunology*
  • Humans
  • Immunoglobulin Isotypes / blood
  • Immunoglobulin Isotypes / immunology
  • Lymphocyte Count
  • Lymphocyte Subsets / immunology
  • Lymphocyte Subsets / metabolism
  • Male
  • Middle Aged
  • Pneumococcal Vaccines / immunology
  • Receptors, Antigen, T-Cell / metabolism
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Virus Diseases / complications
  • Virus Diseases / immunology
  • Young Adult

Substances

  • Immunoglobulin Isotypes
  • Pneumococcal Vaccines
  • Receptors, Antigen, T-Cell