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Lymphoid Reconstitution After Autologous PBSC Transplantation
With FACS-Sorted CD34+ Hematopoietic Progenitors
Catherine Bomberger,
Meeta Singh-Jairam,
Glenn Rodey,
Anastasia Guerriero,
Andrew M. Yeager,
William H. Fleming,
H. Kent Holland, and
Edmund K. Waller
From the Stem Cell Biology Program, Emory University, Department of
Pathology, Emory University, Division of Hematology and Oncology,
Atlanta, GA.
T-cell and B-cell reconstitution was studied in nine patients who
received fluorescence activated cell sorter (FACS)-sorted autologous
CD34+ hematopoietic progenitor cells (HPC). The mean
numbers of T cells (CD3+), B cells
(CD19+) and CD34+ HPC administered to
each patient were .004, .002, and 1.8 × 106 cells/kg,
respectively. After high-dose myeloablative chemotherapy (busulfan,
cyclophosphamide, etoposide) CD34+ HPC were infused and
lymphoid reconstitution was monitored using flow cytometry and reverse
transcriptase-polymerase chain reaction (RT-PCR) amplification of VDJ
T-cell receptor (TcR) sequences. Restoration of normal numbers of
peripheral blood T cells and B cells among recipients of FACS-sorted
CD34+ HPC was delayed compared to recipients of
non-T-cell-depleted PBSC autografts. In both patient groups, the
circulating T cells were primarily CD4 ,
CD8+,   TcR+, and
CD45RO+, CD45RA during the first 2 months
after transplant. Subsequent increases in the frequency of
CD45RA+ CD45RO T cells occurred at 2 to 3 months after transplant, suggesting maturation of CD34+
hematopoietic progenitors to "naive" T cells. Analysis of the TcR
repertoire after hematopoietic reconstitution demonstrated decreased
diversity of V TcR expression associated with global decreases in
the absolute number of total peripheral blood T cells and most V
TcR+ subsets. Three of nine recipients of FACS-sorted
CD34+ HPC demonstrated significant increases in the
percentage of   + peripheral T cells and
CD5+ B cells at 3 to 9 weeks after transplantation, and
all patients had transient oligoclonal expansions of T cells expressing
specific V TcR. Transplantation with highly purified
CD34+ HPC results in reduced diversity of the peripheral
T-cell repertoire during the early post-transplant period compared with
patients receiving unmanipulated or MoAb-depleted transplants.
Blood, Vol. 91 No. 7 (April 1), 1998:
pp. 2588-2600
© 1998 by The American Society of Hematology.
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