| Literature DB >> 25708219 |
Rima M Saliba1, Katayoun Rezvani1, Ann Leen2, Jeffrey Jorgensen3, Nina Shah1, Chitra Hosing1, Simrit Parmar1, Betul Oran1, Amanda Olson1, Gabriela Rondon1, Julianne Chen1, Charles Martinez1, Amir Hamdi1, Rohtesh S Mehta1, Roy F Chemaly4, Ila M Saunders5, Catherine M Bollard6, Elizabeth J Shpall7.
Abstract
Cord blood transplantation (CBT) is curative for many patients with hematologic malignancies but is associated with delayed immune recovery and an increased risk of viral infections compared with HLA-matched bone marrow or peripheral blood progenitor cell transplantation. In this study we evaluated the significance of lymphocyte recovery in 125 consecutive patients with hematologic malignancies who underwent double-unit CBT (DUCBT) with an antithymocyte globulin-containing regimen at our institution. A subset of 65 patients was prospectively evaluated for recovery of T, natural killer (NK), and B cells, and in 46 patients we also examined viral-specific T cell recovery against adenovirus, Epstein-Barr virus, cytomegalovirus, BK virus, respiratory syncytial virus, and influenza antigen. Our results indicate that in recipients of DUCBT, the day 30 absolute lymphocyte count is highly predictive of nonrelapse mortality and overall survival. Immune recovery post-DUCBT was characterized by prolonged CD8+ and CD4+ T lymphopenia associated with preferential expansion of B and NK cells. We also observed profound delays in quantitative and functional recovery of viral-specific CD4+ and CD8+ T cell responses for the first year post-CBT. Taken together, our data support efforts aimed at optimizing viral-specific T cell recovery to improve outcomes post-CBT.Entities:
Keywords: Absolute lymphocyte count; B cells; NK cells; Post-transplant; Post-transplant infections; T cells
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Year: 2015 PMID： 25708219 PMCID： PMC4798431 DOI： 10.1016/j.bbmt.2015.02.017
Source DB: PubMed Journal: Biol Blood Marrow Transplant ISSN： 1083-8791 Impact factor: 5.742