Back to Search
Start Over
Is immunological recovery clinically relevant at 100 days after allogeneic transplantation?
- Source :
- The Korean Journal of Internal Medicine, Vol 35, Iss 4, Pp 957-969 (2020), The Korean Journal of Internal Medicine
- Publication Year :
- 2020
- Publisher :
- The Korean Association of Internal Medicine, 2020.
-
Abstract
- Background/aims Immune reconstitution following allogeneic hematopoietic stem cell transplantation (HSCT) is affected by multiple variables during the transplantation. Methods We assessed the clinical factors contributing to immune function reconstitution at 100 days post-allogeneic HSCT in 114 patients receiving fludarabine-based conditioning. Immunophenotypic analysis using flow cytometry was performed to evaluate the percentage and the absolute numbers of T-cell subsets, natural killer cells, and B-cells as clinical outcomes. Results Tacrolimus-based graft-versus-host disease (GVHD) prophylaxis, T-cell depletion, and acute GVHD were significantly associated with delayed immune reconstitution of T-cell subsets. The incidence of chronic GVHD was significantly increased in the normal recovery group compared to the abnormal group (p = 0.01). Epstein-Barr virus reactivation was more frequently observed in the abnormal group of T-cell subsets (p = 0.045). All viral reactivation events including cytomegalovirus reactivation appeared to be more frequent in the abnormal group of T-cell subsets. Conclusion The immune recovery status post-allogeneic HSCT was affected by GVHD prophylactic regimens, especially in cases receiving tacrolimus-based GVHD prophylaxis, T-cell depletion, and possibly those manifesting acute GVHD. Delayed immune reconstitution might increase the morbidity due to viral reactivation. Treatment strategies are needed to prevent infectious complications and enhance immune reconstitution based on the immune recovery status following allogeneic HSCT with fludarabine-based conditioning.
- Subjects :
- Epstein-Barr Virus Infections
Herpesvirus 4, Human
Allogeneic transplantation
Transplantation Conditioning
medicine.medical_treatment
graft vs host disease
chemical and pharmacologic phenomena
Disease
Hematopoietic stem cell transplantation
treatment outcomes
03 medical and health sciences
Hemato-Oncology
0302 clinical medicine
Immune system
Immunity
immune system diseases
Medicine
Humans
Transplantation, Homologous
business.industry
immunity
Tacrolimus
Fludarabine
Transplantation
surgical procedures, operative
Immunology
hematopoietic stem cell transplantation
030211 gastroenterology & hepatology
Original Article
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20056648 and 12263303
- Volume :
- 35
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Korean Journal of Internal Medicine
- Accession number :
- edsair.doi.dedup.....8917bba9eaede7d3a53bd58d838b9e16