Long-term immune reconstitution after anti-CD52-treated or anti-CD34-treated hematopoietic stem cell transplantation for severe T-lymphocyte immunodeficiency

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:121

Article; Proceedings Paper

Slatter, Mary A.¹  Brigham, Kenneth²  Dickinson, Anne M.²  Harvey, Helen L.¹  Barge, Dawn³  Flood, Terence J.¹  Cant, Andrew J.^1,4  Abinun, Mario^1,4  Gennery, Andrew R.^1,4 

[1] Newcastle Upon Tyne Hosp Fdn Trust, Dept Paediat Immunol, Newcastle Upon Tyne, Tyne & Wear, England

[2] Newcastle Upon Tyne Hosp Fdn Trust, Stem Cell Lab, Newcastle Upon Tyne, Tyne & Wear, England

[3] Newcastle Upon Tyne Hosp Fdn Trust, Reg Immunol Lab, Newcastle Upon Tyne, Tyne & Wear, England

[4] Univ Newcastle Upon Tyne, Inst Cellular Med, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

关键词: severe combined immunodeficiency;    hematopoietic stem cell transplantation;    T-cell depletion;    CD34(+) stem cell selection;    immune reconstitution;   

DOI  :  10.1016/j.jaci.2007.10.035

来源: Elsevier

【 摘 要 】

Background: Results of treatment of severe T-lymphocyte immunodeficiencies by means of hematopoietic stem cell (HSC) transplantation have improved. T cell-depleted haploidentical transplantations are successful if there is no HLA-identical donor. Methods to remove T lymphocytes include addition of anti-CD52 antibodies and CD34(+) HSC selection. Objective: Assessment of long-term immune function is important after these treatments. We looked at immune reconstitution in 36 survivors for more than 2 years after HSC transplantation for severe T-lymphocyte immunodeficiencies and compared engraftment quality between the 2 T-lymphocyte depletion methods. Methods: Chimerism, T- and B-lymphocyte subsets, immunoglobulin levels, and specific antibody production at last follow-up were examined. The X(2) (Fisher exact test) and Wilcoxon rank sum analyses were used to compare the groups. Results: Nineteen patients received anti-CD52-treated and 19 anti-CD34-treated HSCs. More anti-CD52-treated patients had full donor myeloid chimerism (P = .025). All patients had full donor T-lymphocyte chimerism. There was no difference in donor B-lymphocyte chimerism, but significantly more anti-CD52-treated patients had class-switched memory B lymphocytes (P = .024), normal IgG levels, and normal responses to tetanus and Haemophilus influenzae type B vaccination. More anti-CD52-treated patients with common gamma chain or Janus-associated kinase 3 severe combined immunodeficiency had donor B lymphocytes. Conclusion: Long-term T-lymphocyte function is good with either treatment method, with a low incidence of graft-versus-host disease. The results imply more incomplete donor chimerism in anti-CD34-treated patients with less B-lymphocyte function.

【 授权许可】

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