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

Lookup NU author(s): Professor Anne Dickinson, Dr Nicholas Bown, Professor Andrew Cant, Dr Mario Abinun, Professor Andrew GenneryORCiD

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Abstract

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 χ2 (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 γ 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. © 2008 American Academy of Allergy, Asthma & Immunology.

Publication metadata

Author(s): Slatter MA, Brigham K, Dickinson AM, Harvey HL, Barge D, Jackson A, Bown N, Flood TJ, Cant AJ, Abinun M, Gennery AR

Publication type: Article

Publication status: Published

Journal: Journal of Allergy and Clinical Immunology

Year: 2008

Volume: 121

Issue: 2

Pages: 361-367

ISSN (print): 0091-6749

ISSN (electronic): 1097-6825

Publisher: Mosby

URL: http://dx.doi.org/10.1016/j.jaci.2007.10.035

DOI: 10.1016/j.jaci.2007.10.035

PubMed id: 18086494

Notes: Presented in abstract form at the 33rd Annual Meeting of the European Group for Blood and Marrow Transplantation, Lyon, France, March 2007.

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