Immune reconstitution after haematopoietic cell transplantation in children: immunophenotype analysis with regard to factors affecting the speed of recovery.

摘要: Immune reconstitution was studied prospectively in 66 children who underwent 77 haematopoietic cell transplantations (HCT): 46 autologous HCTs 39 patients and 31 allogeneic 27 patients. We the dynamic analysis of immune recovery with regard to potential factors affecting its speed, including age, type HCT, diagnosis, graft-versus-host disease (GvHD) cytomegalovirus (CMV) infection reactivation. Absolute counts different lymphocyte subsets immunoglobulin serum levels were determined peripheral blood on d -7 +16, then at various intervals up 24 months post transplant. Common patterns after both HCT identified: (i) CD4+CD45RO+ T-cell expansion +16; (ii) inverted CD4+:CD8+ ratio from +30 onwards; (iii) rapid natural killer (NK) (CD16+/-CD56+) count normalization. observed prolonged lymphopenia (CD3+, CD3+CD4+, CD4+CD45RA+) until whereas setting CD3+CD4+ cells, naive CD45RA+ returned normal values 9 Age > 10 years coexistence GvHD CMV reactivation associated a substantial delay T- (CD4+, CD45RA+) B-cell HCT. Multidrug prophylaxis resulted impaired only early phase (up 4 months). Our results demonstrated that severely It should be emphasized specific approaches enhance are necessary control minimal residual avoid risk infectious complications setting. Thymic involution seems age