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Characteristics and influencing factors of CD19+ B cell reconstitution in patients following haploidentical/mismatched hematopoietic stem cell transplantation

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Abstract

In patients undergoing hematopoietic stem cell transplantation (HSCT), B cells exert important, prolonged effects that provide protection from infection. In this study, we analyzed characteristics and influencing factors of CD19+ B cell reconstitution in 83 patients who underwent unmanipulated haploidentical/mismatched blood and bone marrow transplantation. Of these patients, 45 % showed a normal CD19+ B cell count at +360 days. Factors associated with lower CD19+ B cell levels were as follows: aGVHD grades II–IV had a trend to affect CD19+ B cell reconstitution at +180 days; clinically extensive cGVHD was significantly associated with CD19+ B cell deficiency at +360 days and serum IgG level at +180 and +360 days; cytomegalovirus (CMV) infection occurred after +38 days was correlated with lower B cell level at both +90 and +360 days, while those occurred before +38 days did not show this effect; glucocorticoids used around +90 and +180 days was associated with lower CD19+ B cell levels at +90 and +360 days, respectively, especially in patients that did not experience extensive cGVHD. In contrast, the number of HLA-mismatched locus positively correlated with CD19+ B cell at +90 days and serum IgG level at +180 days. In conclusion, CD19+ B cell recovery after haploidentical/mismatched HSCT was mainly influenced by GVHD and/or its treatment, CMV infection that occurred later (after +38 days) and use of glucocorticoids. Improvement of B cell recovery is likely to be achieved through effective prophylaxis of GVHD, minimized use of glucocorticoids, and preemptive treatment of CMV infection occurring after +38 days. More HLA-mismatched loci may initiate a stronger humoral response toward alloantigens >180 days after HSCT, which may be beneficial for the eradication of minimal residual disease and protection from infection.

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Acknowledgments

This work was supported by the Beiijng Science Foundation of China (Grant no. 7122193), Higher school specialized research fund for the doctoral program funding issue (Grant no. 20110001110039). This work was also supported by a research fund from the Ministry of Education for excellent doctorial candidates of China.

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Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No 11 Xizhimen South Street, Beijing, 100044, China

    Min Xie, Hai-Xia Fu, Ying-Jun Chang, Lan-Ping Xu, Dai-Hong Liu, Xiao-Hui Zhang, Wei Han, Kai-Yan Liu & Xiao-Jun Huang

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  1. Min Xie
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  2. Hai-Xia Fu
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  3. Ying-Jun Chang
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  8. Kai-Yan Liu
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Correspondence to Xiao-Jun Huang.

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M. Xie and H.-X. Fu contributed equally to this work.

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Xie, M., Fu, HX., Chang, YJ. et al. Characteristics and influencing factors of CD19+ B cell reconstitution in patients following haploidentical/mismatched hematopoietic stem cell transplantation. Int J Hematol 96, 109–121 (2012). https://doi.org/10.1007/s12185-012-1099-5

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  • DOI: https://doi.org/10.1007/s12185-012-1099-5

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