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Blood, 15 May 2007, Vol. 109, No. 10, pp. 4575-4581. Prepublished online as a Blood First Edition Paper on February 1, 2007; DOI 10.1182/blood-2006-07-029090.
TRANSPLANTATION Long-term T-cell reconstitution after hematopoietic stem-cell transplantation in primary T-cell–immunodeficient patients is associated with myeloid chimerism and possibly the primary disease phenotype1 Institut National de la Santé et de la Recherche Médicale (INSERM), Unité (U) 768, Paris, France; Université René Descartes, Paris, France; Hôpital Necker–Enfants Malades, Paris, France; 2 Département de Biothérapies, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Necker–Enfants Malades, Paris, France; 3 Centre d'Etude des Déficits Immunitaires, Hôpital Necker–Enfants Malades, Paris, France; 4 Département de Biostatistique–Hôpital Necker–Enfants Malades, Paris, France; 5 Unité des Virus Lents, Institut Pasteur, Paris; 6 Laboratoire de cytogénétique, Hôpital Necker–Enfants Malades, Paris, France; 7 Laboratoire d'Immunologie, Hôpital Necker–Enfants Malades, Paris, France; 8 Unité d'Immunologie et Hématologie Pédiatrique, Hôpital Necker–Enfants Malades, Paris, France
We studied T-cell reconstitution in 31 primary T-cell–immunodeficient patients who had undergone hematopoietic stem-cell transplantation (HSCT) over 10 years previously. In 19 patients, there was no evidence of myeloid chimerism because little or no myeloablation had been performed. Given this context, we sought factors associated with good long-term T-cell reconstitution. We found that all patients having undergone full myeloablation had donor myeloid cells and persistent thymopoiesis, as evidenced by the presence of naive T cells carrying T-cell receptor excision circles (TRECs). In 9 patients with host myeloid chimerism, sustained thymic output was also observed and appeared to be associated with
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| Copyright © 2007 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||||
c deficiency. It is therefore possible that the complete absence of thymic progenitors characterizing this condition created a more favorable environment for thymic seeding by a population of early progenitor cells with the potential for self-renewal, thus enabling long-term (> 10 years) T-cell production. 
