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Immunobiology

Effect of extended immunosuppressive drug treatment on B cell vs T cell reconstitution in pediatric bone marrow transplant recipients

Bone Marrow Transplantation volume 28, pages 573–580 (2001)Cite this article

Abstract

Allogeneic bone marrow transplantation (BMT) is an effective therapy for a variety of malignancies and blood disorders, but rarely serves as a frontline treatment because of numerous, potential complications. Important and frequent complications relate to the profound immunosuppression that inevitably occurs during the first several months following treatment. To better elucidate and subsequently improve immune reconstitution, we examined T and B cell subsets among 43 pediatric BMT recipients in a retrospective study. We found that the relative numbers of T cells and B cells (T:B ratios) were discordant and highly variable among patients at day ∼100 after BMT. Further investigation of BMT parameters identified a strong correlation between T:B ratios and immunosuppressive drug treatments, providing an explanation for variable lymphocyte reconstitution profiles. Results suggest that: (1) immunosuppressive therapy inhibits B cell expansion more strongly than T cell expansion following BMT; (2) WBC and absolute lymphocyte counts fail to reveal profound B cell immunodeficiencies in some BMT patients; and (3) routine analyses of T:B ratios serve to identify patients warranting close follow-up and extended supportive immunotherapy. Bone Marrow Transplantation (2001) 28, 573–580.

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Acknowledgements

This work was funded in part by grants from the National Institutes of Health, National Cancer Institute: P30-CA21765 and RO1-CA57419, The Assisi Foundation, and the American Lebanese Syrian Associated Charities. We thank our clinical colleagues Drs Malcolm K Brenner, Robert Krance and Helen E Heslop for helping care for patients and initiating lymphocyte analyses. We thank Xin Tong of the Biostatistics and Epidemiology Department of St Jude Children's Research Hospital for assistance with statistical calculations.

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Authors and Affiliations

  1. Department of Immunology, St Jude Children's Research Hospital, Memphis, TN, USA

    S D'Costa & JL Hurwitz

  2. Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, TN, USA

    KS Slobod & N Howlett

  3. Department of Hematology/Oncology, St Jude Children's Research Hospital, Memphis, TN, USA

    E Benaim, L Bowman, J Cunningham & M Holladay

  4. Department of Biostatistics and Epidemiology, St Jude Children's Research Hospital, Memphis, TN, USA

    DK Srivastava

  5. Department of Pediatrics, University of Tennessee, Memphis, TN, USA

    KS Slobod

  6. Department of Pathology, University of Tennessee, Memphis, TN, USA

    JL Hurwitz

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  1. S D'Costa
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D'Costa, S., Slobod, K., Benaim, E. et al. Effect of extended immunosuppressive drug treatment on B cell vs T cell reconstitution in pediatric bone marrow transplant recipients. Bone Marrow Transplant 28, 573–580 (2001). https://doi.org/10.1038/sj.bmt.1703185

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