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

Bone Marrow Transplantation
S D'CostaJ L Hurwitz

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 approximately 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 immu...Continue Reading

References

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Jun 3, 1999·The Pediatric Infectious Disease Journal·J L Hurwitz, K S Slobod

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Citations

Sep 15, 2009·Blood·Alexander Shimabukuro-VornhagenMichael S von Bergwelt-Baildon
Oct 19, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Juan Gea-BanaclocheJohn R Wingard
Mar 2, 2006·Annals of Plastic Surgery·Selahattin OzmenMaria Siemionow
Jan 18, 2005·Clinical Microbiology Reviews·Nina Singh, David L Paterson
Jan 24, 2021·Immunological Reviews·Aravind CherukuriDavid M Rothstein

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