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Blood, 15 December 2007, Vol. 110, No. 13, pp. 4543-4551. Prepublished online as a Blood First Edition Paper on August 1, 2007; DOI 10.1182/blood-2007-05-092130. This Article Full Text (PDF) All Versions of this Article: blood-2007-05-092130v1 110/13/4543    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Komanduri, K. V. Articles by Shpall, E. J. Search for Related Content PubMed PubMed Citation Articles by Komanduri, K. V. Articles by Shpall, E. J. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 25, 2007 Accepted July 23, 2007 Delayed immune reconstitution after cord blood transplantation is characterized by impaired thymopoiesis and late memory T cell skewing Krishna V. Komanduri*, Lisa S. St. John, Marcos de Lima, John McMannis, Steven Rosinski, Ian McNiece, Susan G Bryan, Indreshpal Kaur, Sean Martin, Eric D. Wieder, Laura Worth, Laurence J.N. Cooper, Demetrios Petropoulos, Jeffrey J. Molldrem, Richard E. Champlin, and Elizabeth J. Shpall Dept. of Stem Cell Transplantation and Cellular Therapy, M.D. Anderson Cancer Center, Houston, TX, United States Joint M.D., Ph.D. Graduate Program, University of Colorado, Denver, CO, United States Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, United States * Corresponding author; email: kkomanduri{at}mdanderson.org. Advances in immune assessment, including the development of T cell receptor excision circle (TREC) assays of thymopoiesis, cytokine-flow cytometry assays of T cell function and higher-order phenotyping of T cell maturation subsets have improved our understanding of T cell homeostasis. Limited data exist using these methods to characterize immune recovery in adult cord blood transplant (CBT) recipients, in whom infection is a leading cause of mortality. We now report the results of a single-center prospective study of T cell immune recovery after CBT in a predominantly adult population. Our primary findings include the following: 1) Prolonged T lymphopenia and compensatory expansion of B and NK cells was evident; 2) CBT recipients had impaired functional recovery, though we did observe post-transplant de novo T cell responses to CMV in a subset of patients; 3) Thymopoietic failure characterized post-CBT immune reconstitution, in marked contrast to results in other transplant recipients; and 4) Thymopoietic failure was associated with late-memory T cell skewing. Our data suggest that efforts to improve outcomes in adult CBT recipients should be aimed at optimizing T cell immune recovery. Strategies aimed at improving engraftment of lymphoid precursors, and that facilitate thymoprotection and/or augment thymopoiesis may improve outcomes after CBT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Immune reconstitution after unrelated cord blood transplants in adults Eliane Gluckman Blood 2007 110: 4136. [Full Text] [PDF]

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