Long-term immune reconstitution and clinical outcome after stem cell transplantation for severe T-cell immunodeficiency

J Allergy Clin Immunol. 2007 Oct;120(4):892-9. doi: 10.1016/j.jaci.2007.08.007. Epub 2007 Sep 7.

Abstract

Background: Currently, hematopoietic stem cell transplantation allows long-term survival in a high proportion of infants with congenital severe T-cell immunodeficiency. However, relatively little is known of their long-term quality of life.

Objective: We sought to assess the long-term immune reconstitution and clinical status in children treated with stem cell transplantation for severe T-cell immunodeficiency.

Methods: Immune function and clinical status have been analyzed in a cohort of 40 patients with severe T-cell immunodeficiency who are alive at a follow-up of at least 5 years after transplantation.

Results: Most patients have attained normal T- and B-cell function. Weight and height were normal at last follow-up in most patients. Endocrine and severe neurologic abnormalities have been observed in 17.5% and 10% of the patients, respectively.

Conclusions: These data indicate that with current management strategies, stem cell transplantation can lead to long-term survival and good quality of life in the majority of patients with severe T-cell immunodeficiency.

Clinical implications: Prompt recognition of congenital severe T-cell immunodeficiency, followed by stem cell transplantation, allows excellent perspectives of long-term survival and good quality of life for these otherwise fatal disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases / etiology
  • Child Development
  • Child, Preschool
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Infant
  • Sensation
  • Severe Combined Immunodeficiency / immunology
  • Severe Combined Immunodeficiency / mortality
  • Severe Combined Immunodeficiency / therapy*