Immune reconstitution after autologous selectedperipheral blood progenitor cell transplantation:comparison of two CD34+ cell‐selection systems

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Abstract
BACKGROUND: Selection of CD34+ PBPCs has been applied as a method of reducing graft contamination from neoplastic cells. This procedure seems to delay lymphocyte recovery, while myeloid engraftment is no different from that with unselected PBPC transplants.STUDY DESIGN AND METHODS: Lymphocyte recovery was studied in two groups of patients who underwent autologous CD34+ PBPC transplant with two different technologies (Ceprate SC, Cellpro [n = 17]; CliniMACS, Miltenyi Biotech [n = 13]). The median number of CD34+ cells transfused was 3.88 × 106 per kg and 3.32 × 106 per kg, respectively. Residual CD3 cells × 106 per kg were 4.97 and 0.58, respectively (p = 0.041). Residual CD19 cells × 106 per kg were 1.33 and 0.73, respectively (NS).RESULTS: No differences were found between the two groups in total lymphocyte recovery to >0.5 × 109 per L, which achieved a stable count by Day 30. During the study period, the CD4+ cell count remained below 0.2 × 109 per L, and the B‐cell subset showed a trend toward normalization. CD3/HLA‐DR+ and CD16/56 increased markedly in both groups by Day 30. An increase in CMV (13%) and adenovirus (17.4%) infection was found in both groups.CONCLUSION: Both CD34+ cell selection technologies used here determined an excellent CD34+ cell purity and an optimal depletion of T cells. The high rate of viral complications is probably due to the inability of residual T cells left from the CD34+ cell selection to generate, immediately after transplant, an adequate number of virus‐specific lymphocytes.

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