Immune reconstitution after ASCT
. | 1 mo after ASCT . | 2 mo after ASCT . | 4 mo after ASCT . | 12 mo after ASCT . | Reference value in healthy child . |
|---|---|---|---|---|---|
| CD3+ cells/μL | 40 | 310 | 485 | 1675 | 1020-4160 |
| CD4+ cells/μL | 10 | 25 | 105 | 985 | 525-2860 |
| CD8+ cells/μL | 28 | 320 | 410 | 1035 | 350-2100 |
| CD19+ cells/μL | 10 | 170 | 210 | 600 | 100-780 |
| Proliferative response to PHA, cpm | 1250 | 3000 | 12 115 | 28.900 | 20 000-47 000 |
| Proliferative response to concanavalin-A, cpm | 285 | 4250 | 9760 | 13.345 | 12 000-21 000 |
| Proliferative response to OKT3, cpm | 670 | 1350 | 29 778 | 41.980 | 30 000-52 000 |
| NK activity: target-effector ratio 10:1, % | 6 | 8 | 16 | 15 | 10-20 |
| NK activity: target-effector ratio 30:1, % | 12 | 22 | 31 | 24 | 17-32 |
| NK activity: target-effector ratio 100:1, % | 23 | 41 | 64 | 48 | 28-52 |
| IgG, mg/dL | 180 | 250 | 350 | 745 | 593-1723 |
| IgM, mg/dL | 20 | 25 | 40 | 190 | 36-314 |
| IgA, mg/dL | < 5 | < 5 | 25 | 110 | 33-235 |
. | 1 mo after ASCT . | 2 mo after ASCT . | 4 mo after ASCT . | 12 mo after ASCT . | Reference value in healthy child . |
|---|---|---|---|---|---|
| CD3+ cells/μL | 40 | 310 | 485 | 1675 | 1020-4160 |
| CD4+ cells/μL | 10 | 25 | 105 | 985 | 525-2860 |
| CD8+ cells/μL | 28 | 320 | 410 | 1035 | 350-2100 |
| CD19+ cells/μL | 10 | 170 | 210 | 600 | 100-780 |
| Proliferative response to PHA, cpm | 1250 | 3000 | 12 115 | 28.900 | 20 000-47 000 |
| Proliferative response to concanavalin-A, cpm | 285 | 4250 | 9760 | 13.345 | 12 000-21 000 |
| Proliferative response to OKT3, cpm | 670 | 1350 | 29 778 | 41.980 | 30 000-52 000 |
| NK activity: target-effector ratio 10:1, % | 6 | 8 | 16 | 15 | 10-20 |
| NK activity: target-effector ratio 30:1, % | 12 | 22 | 31 | 24 | 17-32 |
| NK activity: target-effector ratio 100:1, % | 23 | 41 | 64 | 48 | 28-52 |
| IgG, mg/dL | 180 | 250 | 350 | 745 | 593-1723 |
| IgM, mg/dL | 20 | 25 | 40 | 190 | 36-314 |
| IgA, mg/dL | < 5 | < 5 | 25 | 110 | 33-235 |
The patient experienced profound immune impairment of immune function during the first 4 months after the lymphocyte-depleted ASCT. Progressive recovery of both lymphocyte number and of proliferative response to polyclonal activators occurred over time. Detectable natural killer (NK) activity was already present after the first few months following transplantation. Response to nominal antigens (ie, Candida albicans and HCMV) was observed only 9 to 12 months after ASCT (data not shown).