Immune reconstitution in the patients with talasemia major after hematopoietic stem cell transplantation
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Introduction: Beta-thalaccemia (beta-TM) is one of the most common, autosomal recessive inherited hematologic disorder in the world. Since hematopoietic stem cell transplantation (HSCT) is the only curative treatment, determination of cellular immune reconstitution is crucial for understanding of a successful clinical outcome. Here, we evaluated lymphoid reconstitution in pediatric patients with thalassemia major after stem cell transplantation. Material and Methods: The study included 20 patients with beta-thalassemia major who underwent HSCT. We assessed the clinical and laboratory information of the patients retrospectively. Results: After one year from transplantation, all patients were alive and blood transfusion independent. CD4(+) T cell recovery was poor and CD4/CD8 ratio was impaired in the vast majority of the patients. Percentages and absolute counts of the other lymphoid cells generally reached the normal levels within 12 months. Seventeen patients had full donor chimerism while only 3 of 20 had low chimerism levels ranging between 55-86%. Conclusion: Although a successful clinical course and immune reconstitution were observed, the patients should be followed up carefully. Because, the poor engraftment of CD4(+) T lymphocytes may lead severe infections in the patients.