학술논문

B Cell Reconstitution and Influencing Factors After Hematopoietic Stem Cell Transplantation in Children
Document Type
article
Source
Frontiers in Immunology, Vol 10 (2019)
Subject
hematopoietic stem cell transplantation
allogeneic
immune reconstitution
B lymphocyte
subsets
pediatric
Immunologic diseases. Allergy
RC581-607
Language
English
ISSN
1664-3224
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.