Joint Modeling of Immune Reconstitution Post Haploidentical Stem Cell Transplantation in Pediatric Patients With Acute Leukemia Comparing CD34 + -Selected to CD3/CD19-Depleted Grafts in a Retrospective Multicenter Study

Rapid immune reconstitution (IR) following stem cell transplantation (SCT) is essential for a favorable outcome. The optimization of graft composition should not only enable a sufficient IR but also improve graft vs. leukemia/tumor effects, overcome infectious complications and, finally, improve pat...

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Published in:Frontiers in immunology 2018-08, Vol.9, p.1841-1841
Main Authors: Salzmann-Manrique, Emilia, Bremm, Melanie, Huenecke, Sabine, Stech, Milena, Orth, Andreas, Eyrich, Matthias, Schulz, Ansgar, Esser, Ruth, Klingebiel, Thomas, Bader, Peter, Herrmann, Eva, Koehl, Ulrike
Format: Article
Language:English
Subjects:
allogeneic stem cell transplantation
CD3/19 depletion
CD34 selection
children
immune reconstitution
Immunology
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Summary:Rapid immune reconstitution (IR) following stem cell transplantation (SCT) is essential for a favorable outcome. The optimization of graft composition should not only enable a sufficient IR but also improve graft vs. leukemia/tumor effects, overcome infectious complications and, finally, improve patient survival. Especially in haploidentical SCT, the optimization of graft composition is controversial. Therefore, we analyzed the influence of graft manipulation on IR in 40 patients with acute leukemia in remission. We examined the cell recovery post haploidentical SCT in patients receiving a CD34 -selected or CD3/CD19-depleted graft, considering the applied conditioning regimen. We used joint model analysis for overall survival (OS) and analyzed the dynamics of age-adjusted leukocytes; lymphocytes; monocytes; CD3 , CD3 CD4 , and CD3 CD8 T cells; natural killer (NK) cells; and B cells over the course of time after SCT. Lymphocytes, NK cells, and B cells expanded more rapidly after SCT with CD34 -selected grafts (  = 0.036,  = 0.002, and  
ISSN:1664-3224
1664-3224
DOI:10.3389/fimmu.2018.01841