Lymphocyte subset reconstitution after unrelated cord blood or bone marrow transplantation in children.

We report the post-transplant lymphocyte subset recovery of 226 children treated with Unrelated Cord Blood transplant (UCBT) ( n = 112) or Unrelated Bone Marrow Transplant (UBMT) ( n = 114) for malignant or non-malignant diseases. Absolute numbers of natural killer (NK), B and T cells were monitored by flow cytometry up to 5 years post-transplant. Immunological endpoints were: time to achieve a CD3 cell count >0·5 and 1·5 × 10/l, CD4 > 0·2 and 0·5 × 10/l, CD8 > 0·25 × 10/l, CD19 > 0·2 × 10/l, NK > 0·1 × 10/l. These endpoints were analysed through the use of cumulative incidence curves in the context of competing risks. CD8 T cell recovery was delayed after UCBT with a median time to reach CD8 T cells > 0·25 × 10/l of 7·7 months whereas it was 2·8 months in UBMT ( P < 0·001). B cell recovery was better in UCBT, with a median time to reach CD19 cells > 0·2 × 10/l of 3·2 months in UCBT and 6·4 months in UBMT ( P = 0·03). Median time for CD4 T cell and NK cell recovery was similar in UCBT and UBMT. CD4 T cells recovery was negatively correlated to age (better reconstitution in younger patients, P = 0·002). CD8 T cells recovery was shorter in recipients with a positive cytomegalovirus serology ( P = 0·001). [ABSTRACT FROM AUTHOR]