Abstract
B cell reconstitution after hematopoietic stem cell transplantation (HSCT) is variable and influenced by different patient, donor, and treatment related factors. In this review we describe B cell reconstitution after pediatric allogeneic HST, including the kinetics of reconstitution of the different B cell subsets and the development of the B cell repertoire, and discuss the influencing factors. Observational studies show important roles for stem cell source, conditioning regimen, and graft vs. host disease in B cell reconstitution. In addition, B cell recovery can play an important role in post-transplant infections and vaccine responses to encapsulated bacteria, such as pneumococcus. A substantial number of patients experience impaired B cell function and/or dependency on Ig substitution after allogeneic HSCT. The underlying mechanisms are largely unresolved. The integrated aspects of B cell recovery after HSCT, especially BCR repertoire reconstitution, are awaiting further investigation using modern techniques in order to gain more insight into B cell reconstitution and to develop strategies to improve humoral immunity after allogeneic HSCT.
Highlights
Hematopoietic stem cell transplantation (HSCT) is a treatment modality in which hematopoietic stem cells are used as curative therapy for congenital and acquired disorders of the hematopoietic system and metabolic diseases [1]
In this review we summarize the existing knowledge on B cell reconstitution after pediatric allogeneic HSCT and point out the need and challenges for further investigations
In the course of the first year following HSCT, naive mature B cells represent more than 80% of the peripheral blood B lymphocytes
Summary
Hematopoietic stem cell transplantation (HSCT) is a treatment modality in which hematopoietic stem cells are used as curative therapy for congenital and acquired disorders of the hematopoietic system and metabolic diseases [1]. At one year after HSCT, the B cell reconstitution stabilizes reaching age-corrected normal total B cell counts in peripheral blood in most patients (Figure 1B) [16,17,18,19,20]. Each individual appeared to have highly unique and characteristic IGH repertoire of switched memory B-cells, which allowed the investigators to separate donor and recipient derived B cell clones. This showed in some cases persistence of recipient B cells which indicates that recipient B cells may still contribute to protective immunity after HSCT. More in-depth analyses are needed to understand the integrated evolution of cellular and repertoire reconstitution and the influence of different HSCT-related factors on immune repertoire formation and B cell function require after transplantation
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call