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Updated: Sep 7, 2025
Isolation of Precursor B-cell Subsets from Umbilical Cord Blood
Published on: April 16, 2013
Normal B-cell ranges in infants: A systematic review and meta-analysis
Francesco Borriello1, Noemi Pasquarelli2, Lisa Law3
1Generate Biomedicines, Cambridge, Mass.
Insights
This study establishes the first normal reference ranges for B-cell levels in infants during their first year of life. These findings are crucial for monitoring infant immune system development and the impact of therapies.
Area of Science:
- Immunology
- Pediatrics
- Biostatistics
Background:
- B-cell levels are key indicators of infant immune system development.
- No established reference ranges exist for healthy infants' B-cell counts.
- External factors can impact immune development, necessitating reliable B-cell level benchmarks.
Approach:
- Systematic literature review of studies measuring B-cell levels in infants using flow cytometry and CD19 markers.
- Meta-analysis of 28 studies to estimate normal ranges (2.5th-97.5th percentile) by age.
- Continuous age modeling to identify B-cell level peaks and trends.
Key Points:
- Normal B-cell ranges established for cord blood, 0-1 month, 1-6 months, and >6 months old infants.
- Absolute B-cell levels range from 707 cells/μL (cord blood) to 1493 cells/μL (1-6 months).
- B-cell levels peak around week 26 of infancy, with similar trends for percentage estimates.
Conclusions:
- Provides the first age-specific normal reference ranges for infant B-cell levels.
- Essential for assessing infant immune status and response to treatments.
- Facilitates early detection of immune system abnormalities in infants.
Background:
During the first year of life, B-cell level is a valuable indicator of whether external factors, such as exposure to B-cell-depleting therapies, have an adverse impact on immune system development. However, there are no standard reference ranges of B-cell levels in healthy infants by age.
Objective:
Our aim was to estimate the normal range of B-cell levels in infants, by age, during the first year of life by pooling data from published studies.
Methods:
Studies reporting B-cell levels measured by using flow cytometry and CD19 markers in healthy infants were identified via a systematic literature review. Quality and feasibility assessments determined suitability for inclusion in meta-analyses by age group and/or continuous age. Means and normal ranges (2.5th-97.5th percentile) were estimated for absolute and percentage B-cell levels. Sensitivity analyses assessed the impact of various assumptions.
Results:
Of the 37 relevant studies identified, 28 were included in at least 1 meta-analysis. The means and normal ranges of B-cell levels were found to be 707 cells/μL in cord blood (range 123-2324 cells/μL), 508 cells/μL in infants aged 0 to 1 month (range 132-1369 cells/μL), 1493 cells/μL in infants aged 1 to 6 months (range 416-3877 cells/μL), and 1474 cells/μL in infants older than 6 months (range 416-3805 cells/μL). The continuous age model showed that B-cell levels peaked at week 26. Trends were similar for the percentage B-cell estimates and in sensitivity analyses.
Conclusion:
These meta-analyses provide the first normal reference ranges for B-cell levels in infants, by week of age, during the first year of life.
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