Role of transplantation-related factors in the recovery of the lymphocyte compartment following allogeneic hematopoietic stem cell transplantation
DOI:
https://doi.org/10.14748/e7gmet41Keywords:
immune reconstitution, allogeneic stem cell transplantation, lymphocytesAbstract
Introduction:
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative therapy for hematologic malignancies. Post-transplant immune reconstitution is influenced by various factors including donor type, conditioning regimen, graft-versus-host disease (GVHD), and infections. Due to the heterogeneity in immune recovery, monitoring lymphocyte dynamics is essential.
Aim:
The aim of this study was to assess the dynamics of immune reconstitution following allo-HSCT and to evaluate the impact of diagnosis, donor characteristics, and conditioning regimens on lymphocyte subset recovery.
Materials and Methods:
We retrospectively analyzed 89 allo-HSCT recipients. Immune reconstitution was assessed by the quantification of absolute lymphocyte counts and specific lymphocyte subsets (CD3⁺CD4⁺, CD8⁺CD38⁺, CD3⁺CD16/56⁺ NK cells, and CD19⁺ B cells) by flow cytometry analysis on days +30, +100, +180, and +270 post-transplant. Standard statistical methods were used, and p-values were considered significant at p < 0.05.
Results:
Immune recovery varied by diagnosis, with acute myeloid leukemia (AML) patients showing higher CD8⁺CD38⁺ and CD19⁺ cell levels than those with acute lymphoblastic leukemia (ALL) or non-Hodgkin lymphoma (NHL). Donor type significantly affected lymphocyte recovery: related donors led to higher CD3⁺CD4⁺ and CD19⁺ counts compared to unrelated or haploidentical donors. Male donor grafts were associated with higher absolute lymphocyte count (ALC) and CD3⁺CD4⁺ levels. Conditioning regimens also influenced recovery; FluBuATG resulted in lower CD3⁺CD4⁺ counts compared to BuCyATG and TBF-ATG.
Conclusion:
Immune reconstitution after allo-HSCT is shaped by multiple transplant-related factors. Robust recovery was observed in AML patients and those receiving grafts from related male donors. FluBuATG conditioning was linked to delayed CD4⁺ T-cell recovery. These findings support personalized monitoring to improve post-transplant outcomes.
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