Thank you, i was able to access that last link, no problem, and it does say that it is myeloablative. Sometimes i find that i can't access links while others can, maybe it is my server or something.

My adult son had a myeloablative double u cord transplant for relapsed aml. His transplant center followed his t cell count for the purpose of immune system recovery but his cd4 count remains low, he has frequent respiratory type illnesses, 3 years out. So the fact that this was t cell depleted just made me wonder a few things in my head, that was all. And oddly enough, i read an article that the horse atg decreases the t cells whereas the rabbit atg promotes the expansion of.

Things like this intrigue me, and i know other factors play into cd4 recovery such as chemo, tbi, age, immunosuppressants, gvhd. And although i understand cd4 to be t cells, is it the same t cell as in a t cell depletion? Yikes, i don't know why i bother. 

Thanks for posting that article poskinmel, i found it quite interesting.

In response to the article, the facility my son went to would not allow immunizations until the cd4 reached a certain level. That was about 2 years out for my son. Amazing when you consider his cd4 was 37 at 100 days. Almost non-existent and very frightening.

This subject is particularly interesting to me. My husband is 2 and a 1/4 years out from his T-cell depleted transplant. He has still not been cleared to be vaccinated. His CD4 levels are particularly low. The quantity is about 1/2 of where they want it to be before they start revaccinating. The quality of those cells are quite good tho. He has had about 5 colds and fortunately has been able to get better without any major intervention. He has not had to return to the hospital for any of these events. The frustration is that his dr. is still quite cautious and doesn't want him to overdo being in public places and has insisted that he not return to plane travel. I'm not really sure what my question is but I wonder how hardfast the rules should be if the meager immune system that he has seems to be doing the job. The explanation for the pokey return is that in older folk, this is not unusual. He is only 57 but in the transplant world, we understand that to quallify as being on the"older end". Any thoughts?

When i first came to the boards when my son was transplanted, nobody talked cd4's however our transplant center used the cd4 as the determining factor whether my son could go without a mask, fly on a plane, return to college, vaccinations etc. I don't know if being u-cord was a factor, my son was not t cell depleted transplant, however u cord is known to have a slow regeneration of all cell lines. He was also fully myeloablative, from what i understand the radiation and cytoreductive regimen also play a role in the thymic recovery.

I have read alot about t cells and the thymus gland and it sure seems complicating to me and i am not sure that they have all the answers. I do know that the thymus gland is thought to have a major role in t cell maturation and maintaining homeostasis and that with age the thymus gland undergoes physiological changes that makes it less functional. I have read that these changes start occurring in early adulthood thus the recovery of the cd4 count was age dependent. Does the cd4 count ever totally recover, i really don't know? I think alot of it will depend on age, chemotherapy, type of transplant preconditioning regimen.

This article is from 2005, pretty deep, i actually had to print it out and read it numerous times. If anyone has any articles on this subject they found interesting, i would love to read them.

http://www.jci.org/articles/view/22492/version/1

Could be the cord transplant, MW.  I know it all came down to my ANC for me.  Well, except for the vaccinations which I explained above.  That was all about getting off immune suppression and, even though I had to go back on it three months later, they felt okay about vaccinating me at my one-year mark.

Blessings