Published online 4 February 2010
(Haematologica 2010, 10.3324/haematol.2009.018853)
Copyright © 2010 by Ferrata Storti Foundation

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Article

Long-term immune deficiency after allogeneic stem cell transplantation: B cell deficiency is associated with late infections

Elise Corre¹, Maryvonnick Carmagnat², Marc Busson², Regis Peffault de Latour¹, Marie Robin¹, Patricia Ribaud¹, Antoine Toubert², Claire Rabian², Gerard Socié^1,3

¹ Service d'Hématologie-Greffe, Hôpital Saint-Louis, AP-HP, Paris, France
² Laboratoire d'Immunologie et d'Histocompatibilité AP-HP, INSERM UMRS 940, Institut Universitaire d'Hématologie, Paris, France
³ INSERM U728, Institut Universitaire d'Hématologie, Paris, France

Correspondence: Gérard Socié, MD, PhD, Service d’ Hématologie Greffe, & Inserm U728, Hôpital Saint-Louis, 1 Av. Vellefaux, 75010 Paris, France. Phone: international +33.1.42499824. Fax: international +33.1.42499639. E-mail: gerard.socie{at}sls.aphp.fr

ABSTRACT

In 140 consecutive patients who were 2-year disease-free and underwent myeloablative allogeneic transplantation immune reconstitution was analyzed. A CD4 and CD8 defect was observed involving naive, terminally differentiated, memory and competent cells and above limits values for activated subsets. NK cells normalize at 6 months while we observed expansion of CD19+/CD5+ B cells after 3 months and a persisting defect of memory B cells. Chronic GvHD did not influence significantly those parameters for CD8 subsets while strongly affecting the naïve and competent CD4 subsets. But the most profound impact of chronic GvHD was on B cell subsets especially on the memory B population. The cumulative incidence of late severe infections was low (14% at 4 years). Using Cox models, only low B cell counts at 12 (p=.02) & 24 mo (p=.001) were associated with the hazard of developing late infection, in particular if patients did not developed c.GvHD

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