Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients
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. Method...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137922000906 |
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| author | 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 Fábio Araujo Motta Carolina Prando Carmem Bonfim |
| author_facet | 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 Fábio Araujo Motta Carolina Prando Carmem Bonfim |
| author_sort | Aline Risson Belinovski |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-13T07:57:30Z |
| format | Article |
| id | doaj.art-d185cd3e61af429e9c4fde8c79cf830e |
| institution | Directory Open Access Journal |
| issn | 2531-1379 |
| language | English |
| last_indexed | 2024-03-13T07:57:30Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj.art-d185cd3e61af429e9c4fde8c79cf830e2023-06-02T04:23:45ZengElsevierHematology, Transfusion and Cell Therapy2531-13792023-04-01452235244Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patientsAline Risson Belinovski0Polliany Dorini Pelegrina1Alberto Cardoso Martins Lima2Cilmara Cristina Kuwahara Dumke3Adriana Mello Rodrigues4Gisele Loth5Fernanda Moreira de Lara Benini6Ana Luiza Melo Rodrigues7Fábio Araujo Motta8Carolina Prando9Carmem Bonfim10Hospital Pequeno Príncipe, Curitiba, PR, Brazil; Corresponding author at: Hospital Pequeno Príncipe, Serviço de Transplante de Transplante de Medula Óssea - 3° andar. Rua Desembargador Motta, 1070, Curitiba, PR, Brazil. CEP 80250-060.Hospital Pequeno Príncipe, Curitiba, PR, BrazilHospital de Clínicas, Universidade Federal do Paraná (HC UFPR), Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Faculdades Pequeno Príncipe, Curitiba, PR, BrazilHospital Pequeno Príncipe, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Faculdades Pequeno Príncipe, Curitiba, PR, BrazilIntroduction: 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.http://www.sciencedirect.com/science/article/pii/S2531137922000906Hematopoietic stem cell transplantationImmune reconstitutionLymphocyte countLymphocyte subpopulationsPediatrics |
| spellingShingle | 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 Fábio Araujo Motta Carolina Prando Carmem Bonfim Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients Hematology, Transfusion and Cell Therapy Hematopoietic stem cell transplantation Immune reconstitution Lymphocyte count Lymphocyte subpopulations Pediatrics |
| title | Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients |
| title_full | Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients |
| title_fullStr | Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients |
| title_full_unstemmed | Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients |
| title_short | Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients |
| title_sort | immune reconstitution after allogenic stem cell transplantation an observational study in pediatric patients |
| topic | Hematopoietic stem cell transplantation Immune reconstitution Lymphocyte count Lymphocyte subpopulations Pediatrics |
| url | http://www.sciencedirect.com/science/article/pii/S2531137922000906 |
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