eJHaem (Jul 2020)

Immune reconstitution following umbilical cord blood transplantation: IRES, a study of UK paediatric patients

  • John Girdlestone,
  • Meera Raymond,
  • Bronwen Shaw,
  • Sameer Tulpule,
  • Vikesh R. Devlia,
  • Robert Danby,
  • Trudy Ahyee,
  • Aurore Saudemont,
  • Rachael Hough,
  • Paul Veys,
  • Annalisa Ruggeri,
  • Ajay Vora,
  • David I. Marks,
  • Brenda Gibson,
  • Robert Wynn,
  • Alejandro Madrigal,
  • Cristina V. Navarrete

DOI
https://doi.org/10.1002/jha2.12
Journal volume & issue
Vol. 1, no. 1
pp. 208 – 218

Abstract

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Abstract To obtain a qualitative as well as quantitative view immune reconstitution following umbilical cord blood (UCB) transplantation of paediatric patients, we utilised a broad panel of flow cytometry markers to monitor the phenotypes of lymphoid and myeloid cells at 1‐12 months post‐transplant. Samples were received from 46 patients with a median age of 3.3 years and survival was 76% at 1 year. Monocytes were at similar or higher median levels than in adult controls at all times tested, with a high CD16+ proportion in the first 3 months. NK cells were also within adult ranges, with a CD56++ high proportion in the first 6 months. B cell recovery was seen from 2 months in most patients and T cells from 3 months, both were delayed with anti‐thymocyte globulin (ATG) treatment. CD4:CD8 ratios were high in the first 6 months, and the proportion of T cells with recent thymic emigrant and naïve phenotypes rose from 3 months. NK and plasmacytoid dendritic cell numbers remained at reduced levels in patients not surviving to 1 year. Our results can serve as a useful reference for detailed monitoring of immune reconstitution in paediatric recipients of UCB.

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