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Low-Dose Serotherapy Improves Early Immune Reconstitution after Cord Blood Transplantation for Primary Immunodeficiencies

Lookup NU author(s): Dr Zohreh Nademi, Professor Sophie Hambleton, Dr Terence Flood, Professor Andrew Cant, Dr Mario Abinun, Dr Mary Slatter, Dr Andrew Gennery

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Abstract

Cord blood transplantation (CBT) is curative for many primary immunodeficiencies (PIDs) but is associated with risks of viral infection and graft-versus-host disease (GvHD). Serotherapy reduces GvHD but potentially increases the risk of viral infection by delaying immune reconstitution. Because many PID patients have preexisting viral infections, the optimal dose of serotherapy is unclear. We performed a retrospective analysis in 34 consecutive PID patients undergoing CBT and compared immune reconstitution, viral infection, GvHD, mortality, and long-term immune function between high-dose (n = 11) and low-dose (n = 9) serotherapy. Serotherapy dose had no effect on neutrophil engraftment. Median CD3(+) engraftment occurred at 92.5 and 97 days for high- and low-dose serotherapy, respectively. The low-dose serotherapy group had higher CD3(+), CD4(+), and early thymic emigrant counts at 4 months compared with the high-dose group. GvHD severity and number of viral infections did not differ between serotherapy doses. Survival from the transplantation process was 90.9% for high-dose and 100% for low-dose groups. In conclusion, low-dose serotherapy enhanced T cell reconstitution and thymopoiesis during the first year after CBT with no increase in GvHD. (C) 2014 American Society for Blood and Marrow Transplantation.


Publication metadata

Author(s): Lane JR, Evans PTG, Nademi Z, Barge D, Jackson A, Hambleton S, Flood TJ, Cant AJ, Abinun M, Slatter MA, Gennery AR

Publication type: Article

Publication status: Published

Journal: Biology of Blood and Marrow Transplantation

Year: 2014

Volume: 20

Issue: 2

Pages: 243-249

Print publication date: 10/11/2013

ISSN (print): 1083-8791

ISSN (electronic): 1523-6536

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.bbmt.2013.11.005

DOI: 10.1016/j.bbmt.2013.11.005


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