Lymphocyte subset reconstitution after unrelated cord blood or bone marrow transplantation in children

Abstract

We report the post-transplant lymphocyte subset recovery of 226 children Transplant (UBMT) (n = 114) for malignant or non-malignant diseases. Absolute numbers of natural killer (NK), B and T cells were monitored by flow cytometry up to 5 years post-transplant. Immunological endpoints were: time to achieve a CD3+ cell count >0.5 and 1.5 × 109/l, CD4+ > 0.2 and 0.5 × 109/l, CD8+ > 0.25 × 109/l, CD19+ > 0.2 × 109/l, NK > 0.1 × 109/l. These endpoints were analysed through the use of cumulative incidence curves in the context of competing risks. CD8+ T cell recovery was delayed after UCBT with a median time to reach CD8+ T cells > 0.25 × 109/l of 7.7 months whereas it was 2.8 months in UBMT (P < 0.001). B cell recovery was better in UCBT, with a median time to reach CD19+ cells > 0.2 × 109/l of 3.2 months in UCBT and 6.4 months in UBMT (P = 0.03). Median time for CD4+ T cell and NK cell recovery was similar in UCBT and UBMT. CD4+ T cells recovery was negatively correlated to age (better reconstitution in younger patients, P = 0.002). CD8+ T cells recovery was shorter in recipients with a positive cytomegalovirus serology (P = 0.001). © 2010 Blackwell Publishing Ltd.