Pérez-García M, Olaya-Vargas A, Del Campo-Martínez A, Gaytán-Morales F, Mújica-Guzmán F, Juárez-Nicolás F, Mora-Magaña I, Alejandre VA

Language: Spanish
References: 15
Page: 72-79
PDF size: 91.27 Kb.

ABSTRACT

Introduction: The aim of hematopoietic progenitor cell transplants (HPCT) is to implant a healthy system in the place of an unhealthy one. Total immunological recovery is a slow process and often after the transplant remains incomplete. Although the reconstitution of innate immunity is fast, adaptive immunity is seen to be compromised for years, especially in lymphopoiesis of B and T cells. Nk cells reach normal levels from the first weeks until the first 100 days. The reconstitution of T cells is slow and could last more than two years. The function of B cells is measured using its different antibody subclasses. The reconstitution is influenced by age and transplant type. Objective: To describe immunological recovery trend of pediatric patients postransplanted with hematopoietic progenitor cells from 2008-2010. Material and methods: 31 patients (12 females and 19 males) who were subjected to hematopoietic progenitor cell transplants in bone marrow transplantation unit in Pediatrics National Institute (INP) were recruited for the study. The study is retrospective. Autologous transplant was carried out in 2 of the patients while allogenic transplant was done in 29 of them. According to our data source, 14 of the transplants were with umbilical cord cells and 17 with peripheral blood. Subpopulation post-transplant follow-up was carried out by means of flow cytometry using surface monoclonal antibodies: CD3, CD4, CD8, CD19, and CD56 for 3, 6, 9, and 12 months. Results: All the patients showed similar tendency. It was observed that cells with CD3 immunophenotype presented normal values from the beginning at the expense of adequate values of CD8, while the values of CD4 remained low all through the follow-up. There is significant statistical difference between the numbers of CD3 in peripheral blood compared with that of the umbilical cord at 3 months. CD4/CD8 index was found with normal values from the beginning and throughout the follow-up while the absolute values of CD19 and CD56 cell immunophenotypes were found below normal in all the detections. Conclusion: From the data obtained in the lymphocyte subpopulations measurement, incomplete immunological reconstitution at one year was observed not only in peripheral drug but also in umbilical cord. However, we suggest that further studies involving higher number of cases is need to establish a definitive reconstitution pattern.

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