Summary:This retrospective study compares the reconstitution of T, B and NK cells in three groups of patients transplanted for haematological malignancies with grafts from their HLAidentical sibling donors. In all, 15 patients received PBSC after a nonmyeloablative conditioning regimen consisting of fludarabine and 200 cGy TBI, 13 patients received PBSC after myeloablative conditioning and 37 patients received BM after myeloablative conditioning. In the nonmyeloablative group, the NK cells normalised after 1 month, the CD8+ T cells normalised after 3 months, the CD4+ T cells reached near normal values after 9 months and the B cell values were reduced until 12 months after transplant. In the two myeloablative groups, recipients of PBSC had a significantly higher number of CD4+ T cells after 4 months (P ¼ 0.004) and after 12 months (P ¼ 0.001), than recipients of BM. We found no differences in the T cell reconstitution between the two PBSC groups. This was of interest as the recipients of nonmyeloablative conditioning were older (Po0.001) and had a higher occurrence of chronic GVHD (Po0.05) than the recipients of myeloablative conditioning. In contrast, the recipients of nonmyeloablative conditioning had a delayed B cell recovery when compared to the patients who received myeloablative conditioning (P ¼ 0.04). Bone Marrow Transplantation (2003) 32, 65-72. doi:10.1038/sj.bmt.1704084 Keywords: immune reconstitution; nonmyeloablative conditioning regimen; peripheral blood stem cell transplantation Allogeneic haematopoietic stem cell transplantation after nonmyeloablative conditioning is a treatment modality increasingly used for patients with haematological malignancies ineligible for conventional myeloablative BMT because of older age, comorbidity or the high treatmentrelated mortality after conventional BMT in particular diseases. The results of nonmyeloablative stem cell transplantation have so far been promising. 1,2 One advantage of the use of a nonmyeloablative conditioning regimen is the brief granulo-and thrombocytopenia, which allows the procedure to be performed in an outpatient setting. The reconstitution of the T, B and NK cells after stem cell transplantation is however also important for the defence against pathogens, 3 and low counts of CD4+ T cells and of B cells have been associated with an increased risk of infection. 4,5 Thymic function is impaired after conventional haematopoietic stem cell transplantation, and this is partially because of the high-dose radiochemotherapy included in the conditioning regimen. 6 As the thymic activity post-transplant has been shown to be important for the generation of a diverse and efficient T cell response, 7,8 the lower toxicity of a nonmyeloablative conditioning regimen could in theory enhance the T cell reconstitution. In this study, we retrospectively compared the reconstitution of absolute numbers of T, B and NK cells in patients transplanted with PBSC and conditioned with a nonmyeloablative regimen to patients who received conventional myeloablative conditio...