Optimal approach to assessing T-cell function in haematopoietic cell transplant recipients

Joshua M. Dorn, Roshini S. Abraham, Vilmarie Rodriguez, Shakila P. Khan, Heather Stefanski, Avni Joshi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Standardised approaches to functional immune assessment after haematopoietic cell transplantation (HCT) are lacking. A 12-year-old girl with relapsed acute myelogenous leukaemia, 2 years post-unrelated HCT, underwent immunological evaluation prior to receiving live vaccinations. Assessment of standard immune parameters and T-cell proliferation to phytohaemagglutinin was reassuring. She was given Varicella vaccination based on usual post-transplant protocols but was hospitalised 10 days later with localised Varicella infection (vaccine strain). Following recovery, she underwent further assessment that showed reduced T-cell proliferation to an anti-CD3 stimulation panel (anti-CD3 alone, soluble anti-CD3 + anti-CD28 and soluble anti-CD3 + plus exogenous IL-2). On reassessment, 7 months later, T-cell responses to anti-CD3 stimulation were normal and she was revaccinated without further incident. Measurement of T-cell proliferation to anti-CD3 stimulants likely yields more useful information about global T-cell function and should be strongly considered prior to live vaccine administration post-allogeneic haematopoietic transplant.

Original languageEnglish (US)
Article numberbcr-2017-222417
JournalBMJ case reports
Volume2018
DOIs
StatePublished - Jan 23 2018

Bibliographical note

Publisher Copyright:
© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved.

Keywords

  • immunological products and vaccines
  • immunology
  • infections
  • malignant disease and immunosuppression
  • vaccination/immunisation

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