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Long-term lymphocyte subset number reconstitution is unique but comparable between umbilical cord blood and unrelated bone marrow transplantation

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Abstract

The number of umbilical cord blood transplantation (U-CBT) procedures has been growing annually, but little research has been done on long-term immune recovery after U-CBT. Infection risk is high in U-CBT recipients, and this can be partially attributed to immature immunocompetent cells in umbilical cord blood. In this study, we analyzed lymphocyte subset (LST) number to determine the long-term recovery timeline. We included 36 U-CBT and 10 unrelated bone marrow transplantation (U-BMT) recipients who survived more than 2 years after transplantation, and followed them for up to 10 years post-transplant. Recovery kinetics in the early phase post-transplant was different for each LST. Recovery of CD19+ B cells was faster after U-CBT than after U-BMT in the first 5 years after transplantation. Although CD4+ T cells increased in the first several months after U-CBT, long-term cell count recovery was impaired in approximately 20% of patients. Thus, although the LST recovery pattern after U-CBT was unique, LST number recovery was statistically comparable between U-CBT and U-BMT past 5 years post-transplantation.

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Data availability

The data that support the findings of this study are available from the corresponding author, S. Takagi, upon reasonable request.

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Acknowledgements

The authors thank the patients and the donors. We also thank physicians, nurses, pharmacists, transplantation coordinator (Ms. Madoka Narita, Ms. Rumiko Tsuchihashi, Ms. Tomoko Amemiya, Ms. Rina Hino), data managers (Ms. Kaori Kobayashi), secretariat member of Hematopoietic Cell Transplantation Promotion Base Hospital Project (Ms. Naomi Watanabe), and support personnel for their care of the patients involved in the study. We publish this paper with deep gratitude and condolences to Dr. Akiko Yoneyama, who has been the director of the Department of Clinical Laboratory and the Department of Infectious Diseases in Toranomon Hospital. She supported and contributed greatly to the development of umbilical cord blood transplantation at Toranomon Hospital from its earliest days and was a dedicated clinical and research physician. She also laid the foundation for the seamless collaboration between Hematology and Clinical Laboratory and Infectious Diseases Departments in Toranomon Hospital.

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Authors and Affiliations

  1. Department of Clinical Laboratory, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 1050001, Japan

    Keiko Tsumita & Yukako Koike

  2. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    Shinsuke Takagi, Yuki Asano-Mori, Otoya Watanabe, Michiho Shindo, Mitsuhiro Yuasa, Daisuke Kaji, Yuki Taya, Aya Nishida, Hisashi Yamamoto, Go Yamamoto, Naoyuki Uchida & Shuichi Taniguchi

  3. Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan

    Shinsuke Takagi, Yuki Asano-Mori, Hisashi Yamamoto & Atsushi Wake

  4. Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan

    Yuki Asano-Mori, Daisuke Kaji & Yuki Taya

  5. Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan

    Kyosuke Yamaguchi, Kosei Kageyama, Kazuya Ishiwata & Atsushi Wake

  6. Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan

    Hideki Araoka

  7. Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan

    Shigeyoshi Makino

  8. Okinaka Memorial Institute for Medical Research, Tokyo, Japan

    Shinsuke Takagi & Naoyuki Uchida

Authors
  1. Keiko Tsumita
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  2. Shinsuke Takagi
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  3. Yuki Asano-Mori
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  4. Otoya Watanabe
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  5. Michiho Shindo
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  6. Kyosuke Yamaguchi
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  7. Mitsuhiro Yuasa
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  8. Kosei Kageyama
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  9. Daisuke Kaji
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  10. Yuki Taya
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  13. Hisashi Yamamoto
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  14. Hideki Araoka
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  15. Go Yamamoto
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  17. Atsushi Wake
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  18. Naoyuki Uchida
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  19. Shuichi Taniguchi
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  20. Yukako Koike
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Contributions

K. Tsumita, S. Takagi and Y. Koike are principal investigators and take primary responsibility for the paper; K. Tsumita, S. Takagi and Y. Koike wrote the manuscript; S. Takagi, Y.A-M, O.W., M.E., K.Y., M.Y., K.K., D.K., Y.T., A.N., K.I., H.Y., G.Y., A.W., N.U., S. Taniguchi treated patients and reviewed the final manuscript; H.A. and S.M. reviewed the final manuscript; N. Uchida, S. Taniguchi and Y. Koike organized the project.

Corresponding author

Correspondence to Yukako Koike.

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Supplementary Information

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12185_2024_3727_MOESM1_ESM.pptx

Supplementary file1 (PPTX 325 KB) Figure S1 Representatives flowcytometry for each lymphocyte subset. Figure S2 Comparison of immune reconstitution of each lineage after umbilical cord blood transplantation, GVHD prophylaxis method. Figure S3 Comparison of immune reconstitution of each lineage after umbilical cord blood transplantation, acute GVHD severity. Figure S4 Comparison of immune reconstitution of each lineage after umbilical cord blood transplantation, chronic GVHD severity. Figure S5 Comparison of immune reconstitution of CD8+ T cells after umbilical cord blood transplantation, transplanted unit number

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Tsumita, K., Takagi, S., Asano-Mori, Y. et al. Long-term lymphocyte subset number reconstitution is unique but comparable between umbilical cord blood and unrelated bone marrow transplantation. Int J Hematol 119, 573–582 (2024). https://doi.org/10.1007/s12185-024-03727-x

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  • DOI: https://doi.org/10.1007/s12185-024-03727-x

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