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Updated: Jul 17, 2026
Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
T cell regeneration in pediatric allogeneic stem cell transplantation
H Olkinuora1, K Talvensaari, T Kaartinen
1Division of Hematology-Oncology and Stem Cell Transplantation, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. helena.olkinuora@hus.fi
Insights
Impaired T cell regeneration after pediatric stem cell transplants is linked to poor thymic function. Low T cell receptor excision circles (TRECs) and Foxp3 levels predict higher mortality and complications.
Area of Science:
- Immunology
- Pediatric Hematology/Oncology
- Transplantation Science
Background:
- Delayed T cell recovery post hematopoietic stem cell transplantation (HSCT) increases morbidity and mortality risk.
- Thymic function is crucial for T cell regeneration, but its role post-pediatric HSCT requires further elucidation.
Purpose of the Study:
- To evaluate thymic function and its association with T cell regeneration in pediatric HSCT recipients.
- To identify factors influencing T cell recovery and clinical outcomes post-HSCT.
Main Methods:
- Prospective follow-up of 66 pediatric patients for 18 months post-HSCT.
- Naive T cell phenotyping, measurement of T cell receptor excision circles (TRECs), and regulatory T cell Foxp3 expression analysis.
Main Results:
- Lower pre-HSCT TRECs observed in children with malignant vs. non-malignant diseases.
- Slow naive T lymphocyte reconstitution and thymic recovery noted in allogeneic HSCT recipients.
- Low TRECs associated with increased mortality and chronic graft-versus-host disease.
- Low pre-HSCT Foxp3 levels correlated with increased post-HSCT mortality.
- Herpesvirus infections impacted mortality prognosis.
Conclusions:
- Impaired T cell regeneration and thymic dysfunction are associated with clinical post-transplant complications in pediatric allogeneic HSCT.
- TRECs and Foxp3 levels may serve as predictive biomarkers for outcomes in pediatric HSCT.
Abstract:
Delayed and/or insufficient T cell recovery post hematopoietic stem cell transplantation (HSCT) leads to an increased risk of morbidity and mortality. We evaluated thymic function and its association with T cell regeneration post HSCT and identified factors involved in the process among pediatric stem cell transplant recipients. T cell regeneration in 66 pediatric patients was prospectively followed by naive T cell phenotyping, measuring of T cell receptor excision circles (TRECs) and expression of Foxp3 by regulatory T cells for the first 18 months post HSCT. TRECs were lower pre-HSCT in children with a malignant than non-malignant primary disease or immunosuppressed controls (P=0.001). Naive T lymphocyte reconstitution and thymic recovery were slow in the recipients of allogeneic stem cell grafts post HSCT. Infections caused by herpesviruses had a prognostic impact on mortality. Children with low TRECs had a high mortality (P=0.05) and low TRECs were also associated with extensive chronic graft-versus-host disease from 6 months onwards. Low amount of Foxp3 pre-HSCT was associated with an increased mortality post HSCT (P=0.03). Our study indicates an association between impaired T cell regeneration and thymic dysfunction and the clinical post transplant complications in pediatric allogeneic stem cell transplantation.
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