6203
document
Immune reconstitution after allogeneic marrow transplantation compared with blood stem cell transplantation . Allogeneic peripheral blood stem cell grafts contain about 10 times more T and B cells than marrow grafts . Because these cells may survive in transplant recipients for a long time , recipients of blood stem cells may be less immunocompromised than recipients of marrow . Immune reconstitution was studied in 115 patients randomly assigned to receive either allogeneic marrow or filgrastim-mobilized blood stem cell transplantation . Between day 30 and 365 after transplantation , counts of most lymphocyte subsets were higher in the blood stem cell recipients . The difference was most striking for CD4 T cells ( about 4-fold higher counts for CD45RA ( high ) CD4 T cells and about 2-fold higher counts for CD45RA ( low/- ) CD4 T cells ; P < .05 ) . On assessment using phytohemagglutinin and herpesvirus antigen-stimulated proliferation , T cells in the 2 groups of patients appeared equally functional . Median serum IgG levels were similar in the 2 groups . The rate of definite infections after engraftment was 1.7-fold higher in marrow recipients ( P =.001 ) . The rate of severe ( inpatient treatment required ) definite infections after engraftment was 2.4-fold higher in marrow recipients ( P =.002 ) . The difference in the rates of definite infections was greatest for fungal infections , intermediate for bacterial infections , and lowest for viral infections . Death associated with a fungal or bacterial infection occurred between day 30 and day 365 after transplantation in 9 marrow recipients and no blood stem cell recipients ( P =.008 ) . In conclusion , blood stem cell recipients have higher lymphocyte-subset counts and this appears to result in fewer infections . ( Blood . 2001 ; 97:3380-3389 )
6204
Intervention_Surgical
allogeneic marrow transplantation
6205
Intervention_Surgical
blood stem cell transplantation .
6206
Intervention_Surgical
allogeneic marrow or filgrastim-mobilized blood stem cell transplantation .
6207
Intervention_Physical
transplantation
6208
Intervention_Physical
transplantation
6209
Intervention_Physical
marrow
6210
Intervention_Physical
blood stem cell
6211
Outcome_Physical
counts of most lymphocyte subsets
6212
Outcome_Physical
CD4 T cells
6213
Outcome_Physical
CD45RA
6214
Outcome_Physical
CD4 T cells
6215
Outcome_Physical
T cells
6216
Outcome_Other
appeared equally functional
6217
Outcome_Physical
Median serum IgG levels
6218
Outcome_Physical
rate of definite infections after engraftment
6219
Outcome_Physical
rate of severe ( inpatient treatment required ) definite infections after engraftment
6220
Outcome_Physical
difference in the rates of definite infections
6221
Outcome_Mortality
Death
6222
Outcome_Physical
lymphocyte-subset counts
6223
Participant_Condition
allogeneic marrow transplantation compared with blood stem cell transplantation .