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Blood, Vol. 93 No. 2 (January 15), 1999:
pp. 467-480
Comparison of Immune Reconstitution After Unrelated and Related
T-Cell-Depleted Bone Marrow Transplantation: Effect of Patient
Age and Donor Leukocyte Infusions
T.N. Small,
E.B. Papadopoulos,
F. Boulad,
P. Black,
H. Castro-Malaspina,
B.H. Childs,
N. Collins,
A. Gillio,
D. George,
A. Jakubowski,
G. Heller,
M. Fazzari,
N. Kernan,
S. MacKinnon,
P. Szabolcs,
J.W. Young, and
R.J. O'Reilly
From Memorial Sloan-Kettering Cancer Center, New York, NY.
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.
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J. A. Shizuru, I. L. Weissman, R. Kernoff, M. Masek, and Y. C. Scheffold
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PNAS,
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D. L. Porter, R. H. Collins Jr, C. Hardy, N. A. Kernan, W. R. Drobyski, S. Giralt, M. E.D. Flowers, J. Casper, A. Leahey, P. Parker, et al.
Treatment of relapsed leukemia after unrelated donor marrow transplantation with unrelated donor leukocyte infusions
Blood,
February 15, 2000;
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[Abstract]
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C. J. Wu, A. Chillemi, E. P. Alyea, E. Orsini, D. Neuberg, R. J. Soiffer, and J. Ritz
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Blood,
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[Abstract]
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J. A. Shizuru, I. L. Weissman, R. Kernoff, M. Masek, and Y. C. Scheffold
Purified hematopoietic stem cell grafts induce tolerance to alloantigens and can mediate positive and negative T cell selection
PNAS,
August 15, 2000;
97(17):
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[Abstract]
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