Rapid immunologic reconstitution following transplantation with mobilized peripheral blood stem cells as compared to bone marrow

Abstract

Summary:ABMT may contribute to an improved clinical outcome. Further, patients receiving a PSCT may be more A majority of patients with intermediate or high-grade responsive to adjuvant immunotherapy following transnon-Hodgkin's lymphoma (NHL) who are treated with plantation. high-dose chemotherapy (HDT) and hematopoietic stem Keywords: PSCT; BMT; immunity; T cell; NHL; NK cell transplantation subsequently relapse. Until recently, cell F transplantation was associated with high morbidity and mortality and the focus was on improving the safety of this procedure. However, the use of growth factors and other supportive measures has successfully reduced High-dose chemotherapy (HDT) supported by hematopotreatment mortality to less than 5%. Therefore, new ietic stem cell transplantation and growth factor adminisstrategies need to be developed to eliminate the growth tration is increasingly used for patients with cancer. 1-3 Leuof any occult tumor cells reinfused with the stem cell kocyte and platelet recovery is more rapid following products and the tumor cells remaining in the patient.peripheral blood stem cell transplantation (PSCT) as comOne approach is to improve the immune function of the pared to bone marrow autografts (ABMT), if the peripheral patients by a more rapid immune reconstitution and stem cells (PSC) are collected after mobilization with hemaugmentation of effector cell function. We report studatopoietic growth factors, chemotherapy, or both. [4][5][6][7][8] In ies comparing immune recovery following HDT and addition, one retrospective study suggested an increase in autologous peripheral stem cell transplantation (PSCT) the progression-free interval following PSCT with steady as compared to autologous bone marrow transplanstate PSC as compared to ABMT, 9 although this obsertation (ABMT). These studies examined patients with vation requires confirmation as well as demonstration in a intermediate and high-grade non-Hodgkin's lymphoma prospectively randomized trial. 4,10,11 (NHL) who were treated with HDT and PSCT (n = 56) PSCT 6,12 may result in an earlier reconstitution of or ABMT (n = 60). The PSCT patients had a signifiimmune function following HDT as compared to cantly faster recovery of circulating monocytes (CD14 + ABMT 13,14 perhaps due to the lymphocytes that are trans- cells), natural killer ((NK) CD56 + ) cells, T helper (CD4 + )fused in the PSC product. To date, there have been limited cells, TCR␥/␦ cells, and naive T lymphocytes and conflicting studies on immune reconstitution following (CD45RA + ). Following ABMT there was a significantly PSCT and ABMT in humans. [15][16][17][18] Overall, there appears to more rapid increase in the frequency of T be wide phenotypic variability of cells in the suppressor/effector (CD8 + ) cells, B (CD19 + ) cells, CD34 + apheresis/transplant products themselves. 14 A significant cells, polymorphonuclear leukocytes (PMN) and memincrease in the frequency of CD8 + cells in the peripheral ory T lymphocytes (CD45RO + ). The CD4:CD8 and blood (PB) following both f...

Effective T cell regeneration following high-dose chemotherapy rescued with CD34+ cell enriched peripheral blood progenitor cells in children

“…[31][32][33][34] These studies also showed a more rapid regeneration of a normal CD4/CD8 ratio. In the autologous setting Talmadge et al 31 observed a normalised CD4/CD8 ratio and an improved cytotoxic and proliferative response even 3 months after PBPC treatment.…”

“…17,42 A high stem cell support may also be critical to a rapid reconstitution of T cells. 31,32 One recent study by Carabasi et al 43 investigating 10 adult patients after allogeneic CD34 + selected PBPC transplantation using Ͼ9 × 10 6 /kg CD34 + cells, median, showed a rapid normalisation of the CD4/CD8 ratio even by 2 months and a regrowth of CD3 + /CD45RA + cells, indicating a regeneration via newly produced T cells.…”

Pleural Cryptococcosis with Idiopathic CD4 Positive T-lymphocytopenia

“…CD95 (Apo-1/Fas) is a member of the TNF/nerve growth factor superfamily that can directly transduce an apoptotic death signal on trimerization with Fas ligand (CD95L) or Fas-specific Abs (25,26). Fas is expressed on the surface of various cell types, including T cells, B cells, and macrophages, as well as cells of the liver, spleen, lung, testis, heart, brain, and intestine (27,28). Apoptosis provides one mechanism for the regulation of peripheral CD4 positive T-cell homeostasis.…”

Persistent changes in the immune system 4–10 years after ABMT

“…The changes in the immune system over the first few months and years after ABMT and PBSCT have been extensively studied. 5,6 It is, however, still an open question whether complete normalization of CD4 ϩ T cells will occur in these patients.…”