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Comparison of immune reconstitution after unrelated and related T-cell- depleted bone marrow transplantation: Effect of patient age and donor leukocyte infusions

Publication ,  Journal Article
Small, TN; Papadopoulos, EB; Boulad, F; Black, P; Castro-Malaspina, H; Childs, BH; Collins, N; Gillio, A; George, D; Jakubowski, A; Heller, G ...
Published in: Blood
1999

Unrelated bone marrow transplantation (BMT) is often complicated by fatal opportunistic infections. To evaluate features unique to immune reconstitution after unrelated BMT, the lymphoid phenotype, in vitro function, and life-threatening opportunistic infections after unrelated and related T-cell-depleted (TCD) BMT were analyzed longitudinally and compared. The effects of posttransplant donor leukocyte infusions to treat or prevent cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infections on immune reconstitution were also analyzed. This study demonstrates that adult recipients of TCD unrelated BMTs experience prolonged and profound deficiencies of CD3+, CD4+, and CD8+ T-cell populations when compared with pediatric recipients of unrelated BMT and adults after related BMT (P < .01), that these adults have a significantly increased risk of life-threatening opportunistic infections, and that the rate of recovery of CD4 T cells correlates with the risk of developing these infections. Recovery of normal numbers of CD3+, CD8+, and CD4+ T-cell populations is similar in children after related or unrelated BMT. This study also demonstrates that adoptive immunotherapy with small numbers of unirradiated donor leukocytes can be associated with rapid restoration of CD3+, CD4+, and CD8+ T-cell numbers, antigen-specific T-cell responses, and resolution of CMV- and EBV-associated disease after unrelated TCD BMT.

Duke Scholars

Published In

Blood

ISSN

0006-4971

Publication Date

1999

Volume

93

Issue

2

Start / End Page

467 / 480

Related Subject Headings

  • Immunology
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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MLA
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Small, T. N., Papadopoulos, E. B., Boulad, F., Black, P., Castro-Malaspina, H., Childs, B. H., … O’Reilly, R. J. (1999). Comparison of immune reconstitution after unrelated and related T-cell- depleted bone marrow transplantation: Effect of patient age and donor leukocyte infusions. Blood, 93(2), 467–480.
Small, T. N., E. B. Papadopoulos, F. Boulad, P. Black, H. Castro-Malaspina, B. H. Childs, N. Collins, et al. “Comparison of immune reconstitution after unrelated and related T-cell- depleted bone marrow transplantation: Effect of patient age and donor leukocyte infusions.” Blood 93, no. 2 (1999): 467–80.
Small TN, Papadopoulos EB, Boulad F, Black P, Castro-Malaspina H, Childs BH, et al. Comparison of immune reconstitution after unrelated and related T-cell- depleted bone marrow transplantation: Effect of patient age and donor leukocyte infusions. Blood. 1999;93(2):467–80.
Small TN, Papadopoulos EB, Boulad F, Black P, Castro-Malaspina H, Childs BH, Collins N, Gillio A, George D, Jakubowski A, Heller G, Fazzari M, Kernan N, MacKinnon S, Szabolcs P, Young JW, O’Reilly RJ. Comparison of immune reconstitution after unrelated and related T-cell- depleted bone marrow transplantation: Effect of patient age and donor leukocyte infusions. Blood. 1999;93(2):467–480.

Published In

Blood

ISSN

0006-4971

Publication Date

1999

Volume

93

Issue

2

Start / End Page

467 / 480

Related Subject Headings

  • Immunology
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology