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Immunology

Immune reconstitution after haploidentical hematopoietic cell transplantation: impact of reduced intensity conditioning and CD3/CD19 depleted grafts

Leukemia volume 25, pages 121–129 (2011)Cite this article

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Abstract

Haploidentical hematopoietic cell transplantation (HHCT) using CD34 selected grafts is complicated by slow engraftment and immune reconstitution. Engraftment and immune reconstitution might be improved using CD3/CD19-depleted grafts and reduced intensity conditioning (RIC). We report on 28 patients after HHCT with CD3/CD19-depleted grafts using RIC, which were prospectively evaluated for engraftment and immune reconstitution. Engraftment was rapid with full chimerism reached on day +15 after HHCT. T-cell reconstitution was delayed with a median of 205 CD3+ cells/μl, 70 CD3+CD4+ cells/μl and 66 CD3+ CD8+ cells/μl on day +100, respectively. A skewed T-cell receptor-Vβ repertoire with oligoclonal T-cell expansions to day +100 and normalization after day +200 was observed. B-cell reconstitution was slow with a median of 100 CD19+ CD20+ cells/μl on day +150. Natural killer (NK) cell engraftment was fast reaching normal values on day +20. An increased natural cytotoxicity receptor and NKG2A, but decreased NKG2D and KIR expressions were observed on NK cells until day +100. We observed a positive impact of donor lymphocyte infusions on immune reconstitution. In conclusion, after HHCT, using CD3/CD19-depleted grafts and RIC, T- and B-cell reconstitution is delayed, whereas NK-cell reconstitution occurs early and fast.

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Acknowledgements

We would like to thank Susanne Schneider, Stephanie Katz and Stefanie Ackermann for their excellent technical assistance. Furthermore we thank the nurses and stuff of our outpatient department and transplantation unit.

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Authors and Affiliations

  1. Department of Hematology & Oncology, Medical Center, University of Tuebingen, Tuebingen, Germany

    B Federmann, M Hägele, S Wirths, C Faul, W Vogel, L Kanz & W A Bethge

  2. Department of Hematology & Oncology, University Children's Hospital, University of Tuebingen, Tuebingen, Germany

    M Pfeiffer, M Schumm & R Handgretinger

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  1. B Federmann
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Correspondence to W A Bethge.

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Federmann, B., Hägele, M., Pfeiffer, M. et al. Immune reconstitution after haploidentical hematopoietic cell transplantation: impact of reduced intensity conditioning and CD3/CD19 depleted grafts. Leukemia 25, 121–129 (2011). https://doi.org/10.1038/leu.2010.235

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