Comparison of reference values for immune recovery between event-free patients receiving haploidentical allografts and those receiving human leukocyte antigen-matched sibling donor allografts

Abstract

To establish optimal reference values for recovered immune cell subsets, we prospectively investigated post-transplant immune reconstitution (IR) in 144 patients who received allogeneic stem cell transplantation (allo-SCT) and without showing any of the following events: poor graft function, grades II‒IV acute graft-versus-host disease (GVHD), serious chronic GVHD, serious bacterial infection, invasive fungal infection, or relapse or death in the first year after transplantation. IR was rapid in monocytes, intermediate in lymphocytes, CD3⁺ T cells, CD8⁺ T cells, and CD19⁺ B cells, and very slow in CD4⁺ T cells in the entire patient cohort. Immune recovery was generally faster under HLA-matched sibling donor transplantation than under haploidentical transplantation. Results suggest that patients with an IR comparable to the reference values display superior survival, and the levels of recovery in immune cells need not reach those in healthy donor in the first year after transplantation. We suggest that data from this recipient cohort should be used as reference values for post-transplant immune cell counts in patients receiving HSCT.

Keywords

immune reconstitution / hematopoietic stem cell transplantation / event-free patients / reference range

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Acknowledgements

This work was supported in part by the National High Technology Research and Development Program of China (863 Program; No. 2013AA020401) and the National Natural Science Foundation of China (No. 81470342). We thank the faculty members who collected the samples and analyzed the flow cytometric data.

Compliance with ethics guidelines

Xuying Pei, Xiangyu Zhao, Yu Wang, Lanping Xu, Xiaohui Zhang, Kaiyan Liu, Yingjun Chang, and Xiaojun Huang do not have conflict of interest to declare. All procedures were performed in accordance with the ethical standards of the concerned committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975 (revised 2000) (5). Informed consent was obtained from all patients included in this study.

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