BACKGROUND: Results of treatment of severe T-lymphocyte immunodeficiencies by means of hematopoietic stem cell (HSC) transplantation have improved. T cell-depleted haploidentical transplantations are successful if there is no HLA-identical donor. Methods to remove T lymphocytes include addition of anti-CD52 antibodies and CD34(+) HSC selection. OBJECTIVE: Assessment of long-term immune function is important after these treatments. We looked at immune reconstitution in 36 survivors for more than 2 years after HSC transplantation for severe T-lymphocyte immunodeficiencies and compared engraftment quality between the 2 T-lymphocyte depletion methods. METHODS: Chimerism, T- and B-lymphocyte subsets, immunoglobulin levels, and specific antibody production at last follow-up were examined. The chi(2) (Fisher exact test) and Wilcoxon rank sum analyses were used to compare the groups. RESULTS: Nineteen patients received anti-CD52-treated and 19 anti-CD34-treated HSCs. More anti-CD52-treated patients had full donor myeloid chimerism (P = .025). All patients had full donor T-lymphocyte chimerism. There was no difference in donor B-lymphocyte chimerism, but significantly more anti-CD52-treated patients had class-switched memory B lymphocytes (P = .024), normal IgG levels, and normal responses to tetanus and Haemophilus influenzae type B vaccination. More anti-CD52-treated patients with common gamma chain or Janus-associated kinase 3 severe combined immunodeficiency had donor B lymphocytes. CONCLUSION: Long-term T-lymphocyte function is good with either treatment method, with a low incidence of graft-versus-host disease. The results imply more incomplete donor chimerism in anti-CD34-treated patients with less B-lymphocyte function.
BACKGROUND: Results of treatment of severe T-lymphocyte immunodeficiencies by means of hematopoietic stem cell (HSC) transplantation have improved. T cell-depleted haploidentical transplantations are successful if there is no HLA-identical donor. Methods to remove T lymphocytes include addition of anti-CD52 antibodies and CD34(+) HSC selection. OBJECTIVE: Assessment of long-term immune function is important after these treatments. We looked at immune reconstitution in 36 survivors for more than 2 years after HSC transplantation for severe T-lymphocyte immunodeficiencies and compared engraftment quality between the 2 T-lymphocyte depletion methods. METHODS: Chimerism, T- and B-lymphocyte subsets, immunoglobulin levels, and specific antibody production at last follow-up were examined. The chi(2) (Fisher exact test) and Wilcoxon rank sum analyses were used to compare the groups. RESULTS: Nineteen patients received anti-CD52-treated and 19 anti-CD34-treated HSCs. More anti-CD52-treated patients had full donor myeloid chimerism (P = .025). All patients had full donor T-lymphocyte chimerism. There was no difference in donor B-lymphocyte chimerism, but significantly more anti-CD52-treated patients had class-switched memory B lymphocytes (P = .024), normal IgG levels, and normal responses to tetanus and Haemophilus influenzae type B vaccination. More anti-CD52-treated patients with common gamma chain or Janus-associated kinase 3 severe combined immunodeficiency had donor B lymphocytes. CONCLUSION: Long-term T-lymphocyte function is good with either treatment method, with a low incidence of graft-versus-host disease. The results imply more incomplete donor chimerism in anti-CD34-treated patients with less B-lymphocyte function.
Authors: Elie Haddad; Brent R Logan; Linda M Griffith; Rebecca H Buckley; Roberta E Parrott; Susan E Prockop; Trudy N Small; Jessica Chaisson; Christopher C Dvorak; Megan Murnane; Neena Kapoor; Hisham Abdel-Azim; Imelda C Hanson; Caridad Martinez; Jack J H Bleesing; Sharat Chandra; Angela R Smith; Matthew E Cavanaugh; Soma Jyonouchi; Kathleen E Sullivan; Lauri Burroughs; Suzanne Skoda-Smith; Ann E Haight; Audrey G Tumlin; Troy C Quigg; Candace Taylor; Blachy J Dávila Saldaña; Michael D Keller; Christine M Seroogy; Kenneth B Desantes; Aleksandra Petrovic; Jennifer W Leiding; David C Shyr; Hélène Decaluwe; Pierre Teira; Alfred P Gillio; Alan P Knutsen; Theodore B Moore; Morris Kletzel; John A Craddock; Victor Aquino; Jeffrey H Davis; Lolie C Yu; Geoffrey D E Cuvelier; Jeffrey J Bednarski; Frederick D Goldman; Elizabeth M Kang; Evan Shereck; Matthew H Porteus; James A Connelly; Thomas A Fleisher; Harry L Malech; William T Shearer; Paul Szabolcs; Monica S Thakar; Mark T Vander Lugt; Jennifer Heimall; Ziyan Yin; Michael A Pulsipher; Sung-Yun Pai; Donald B Kohn; Jennifer M Puck; Morton J Cowan; Richard J O'Reilly; Luigi D Notarangelo Journal: Blood Date: 2018-08-28 Impact factor: 22.113
Authors: Rebecca H Buckley; Chan M Win; Barry K Moser; Roberta E Parrott; Elisa Sajaroff; Marcella Sarzotti-Kelsoe Journal: J Clin Immunol Date: 2012-09-22 Impact factor: 8.317