Abstract 4483

Introduction

Reconstitution of immunity is considered as one of the most important factors predicting outcome after hematopoietic stem cell transplantation (HSCT). Age of the recipient as well as graft quality reflect on this process however this influence is not completely understood yet. In this study we aimed to evaluate the influence of graft quality on recovery of lymphocyte subpopulation.

Patients and Methods

The total number of 63 patients who underwent allogeneic transplantation in one center between May 2002 and November 2008, were included into the study. Median age of the patient was 8,6 (range 0.2-18) yrs. Patients were divided into 2 age groups: group 1 (n=26) children age 0,2-7 and group 2 (n=37) children >7 yrs. In all cases quality of graft were assessed by counting WBC, CD34 cells and CFU-GEMM. 45 patients (21 in group 1 and 24 in group 2) were available for evaluation of immune reconstitution: in those patients the absolute number of lymphocytes CD3/CD19 (B) cells, CD3/CD4 (T helper) cell, CD3/CD8 (T suppressor) cells and CD3/CD16+56 (NK) cells were measured 3 and 6 months after transplantation.

Results

Younger children (group 1) received higher median number of transplanted nucleated cells (4.9×108 vs 2.5×108, p=0.008), CD34 cells (5.6×106 vs 2.1×106, p=0.02) and CFU-GEMM (2.25×104 vs 1.17×104, p=0.01) than older ones (group 2). No differences were found in absolute values of B, T-helper, T-suppressor and NK cells at 3 and 6 months after transplantation (Table 1). In older children (group 2), but not in younger ones, the number of GFU-GEMM transplanted negatively correlated with number of T-suppressor cells 3 months post HSCT (p<0,05; r=-0,7) and positively with number of T-helper cells 6 moths after HSCT (p<0,05; r=0,73).

Time after HSCTMedian number of T-helper cells/ ul
Median number of T-suppressor cells/ul
Age 0.2-7 years (n=21)Age >7years (n=24)Age 0.2-7 years (n=21)Age >7years (n=24)
3 months 183 163 483 420 
6 months 361 346 742 1011 
Time after HSCTMedian number of T-helper cells/ ul
Median number of T-suppressor cells/ul
Age 0.2-7 years (n=21)Age >7years (n=24)Age 0.2-7 years (n=21)Age >7years (n=24)
3 months 183 163 483 420 
6 months 361 346 742 1011 
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Conclusions

Number of CFU-GEMM infused influences immunologic recovery in children older than 7 years after HSCT. Graft quality correlates with number of T-suppressor cells and T-helper cells during first 6 months after HSCT and these changes may contribute to post transplant complications.

Supported by grant MNiSW of Poland N407 117 35

Disclosures:

No relevant conflicts of interest to declare.

Topics:
child, hematopoietic stem cell transplantation, immunologic recovery, tissue transplants, cd34 antigens, transplantation, cd19 antigens, transplant complications, transplantation, homologous, helper-inducer t-lymphocytes

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2009 by The American Society of Hematology
2009
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