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Improved immune reconstitution after allotransplantation of peripheral
blood stem cells instead of bone marrow
HD Ottinger, DW Beelen, B Scheulen, UW Schaefer and H Grosse-Wilde
Institute of Immunology, University Hospital of Essen, Germany.
Clinical studies are evaluating possible advantages of allogeneic
peripheral blood stem cell transplantation (PBSCT) over bone marrow
transplantation (BMT). We compared immune reconstitution after PBSCT (n =
20) and BMT (n = 20) in terms of lymphocyte subset counts and proliferative
in vitro responses to mitogens and recall antigens (follow-up: 5 to 11
months posttransplant). Additionally, 10 PBSC harvests and 10 marrow
harvests were analyzed for their composition of immunocompetent cells.
Compared with BMT patients, PBSCT recipients had PB counts of naive
(CD4+CD45RA+) and memory (CD4+CD45RO+) helper T cells and of B cells
(CD19+) that were elevated (P < .003, P < .001, and P < .004,
respectively) and proliferative responses to phytohemagglutinin (P <
.0001), pokeweed mitogen (P < .02), Tetanus toxoid (P < .0005), and
Candida (P < .004) that were increased. PBSCT recipients received a mean
of 188 (range, 44 to 280) x 10(6) naive helper T cells and 169 (range, 18
to 296) x 10(5) memory helper T cells per kilogram; the corresponding
numbers for BMT recipients were 11 (range, 4 to 24) and 10 (range, 1 to 22)
x 10(5) cells per kilogram, respectively. The question of whether the
documented improved in vitro immune competence after PBSCT is associated
with a lower incidence of infectious complications in vivo still needs
further study.
Volume 88,
Issue 7,
pp. 2775-2779,
10/01/1996
Copyright © 1996 by The American Society of Hematology
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