Immune reconstitution after allogenic stem cell transplantation: An observational study in pediatric patients
Hematol., Transfus. Cell Ther. (Impr.)
;
45(2): 235-244, Apr.-June 2023. tab, graf, ilus
Article
Dans Anglais
| LILACS
| ID: biblio-1448357
ABSTRACT
Abstract Introduction The immune reconstitution (IR) after the allogenic hematopoietic stem cell transplantation (allo-HSCT) is a progressive process intrinsically correlated to the therapeutic success. It is essential to understand the interfering factors in IR to prevent the HSCT-related mortality. Methods We retrospectively evaluated the clinical outcomes, absolute lymphocyte counts (ALCs) and lymphocyte subtypes at different time-points of 111 pediatric patients with allogeneic HSCT for malignant and non-malignant diseases from 2013 to 2018. Results The ALCs gradually increased on D+30, D+100, and D+180 (medians 634/μL, 1022/μL and 1541/μL, respectively). On D+100, the CD3+CD8+ achieved the highest recovery rate (68%), followed by the CD16+CD56+ (47%), CD3+CD4+ (39%) and CD19+ (8%). The adequate ALC recovery was associated with age < 8 years, bone marrow grafts, myeloablative conditioning, non-use of serotherapy and non-haploidentical donors. The ALC and CD3+CD8+ on D+100 counts were higher in patients with the cytomegalovirus infection. The CD3+CD4+ recovery was associated with an age < 8 years, a non-malignant disease and a lower incidence of acute graft-versus-host disease ≥ grade 2. Furthermore, the ALC recovery on D+100 resulted in a higher overall survival, regardless of the disease type (HR 3.65, 1.05 - 12.71, p= 0.04). Conclusion Several factors influenced the IR after the allo-HSCT. The ALC ≥ 500/μL on D+100 was a simple IR predictor of survival, easily available to resource-limited centers.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Pédiatrie
/
Transplantation de cellules souches hématopoïétiques
/
Reconstitution immunitaire
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Adolescent
/
Adulte
/
Enfant
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Hematol., Transfus. Cell Ther. (Impr.)
Thème du journal:
Hematologia
/
TransfusÆo de Sangue
Année:
2023
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Hospital Pequeno Príncipe/BR
/
Universidade Federal do Paraná/BR
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