재발한 전이성 유방암 환자에서의 고용량 Paclitaxel 화학요법 및 CD34+ 조혈모세포이식

김병수,서재홍,최철원,신상원,김열홍,김준석 대한조혈모세포이식학회 2000 대한조혈모세포이식학회지 Vol.5 No.2

배경:저자 등은 고려대 의료원에서 유방암의 수술 및 anthracycline을 포함한 화학요법 후 재발한 불량한 예후인자를 지닌 전이성 유방암 환자들에게 시행한 고용량 paclitaxel 화학요법 후 Immune-magnetic 법으로 채집된 자가 CD34+ 조혈모세포이식의 경험을 보고하고자 한다. 방법:수술 및 CAF (cyclophosphamide, adriamycin, 5-FU) 화학요법 후 관해를 유지하다가 전이성으로 재발한 32~59세(중앙값: 40세)의 유방암 환자 8명을 대상으로 하였다. 화학요법 후 재발 발견까지의 기간은 7~46개월이었다. 우선 paclitaxel (175 mg/m2) 및 ifosfamide (1,800 mg/m2) 요법을 4회 실시하였고, 모두에서 부분 반응 이상의 효과가 관찰되었다. CD34+ 조혈모세포는 수술실에서 채집된 골수혈로부터 CEPRATEⓡ System을 이용하여 분리한 다음, controlled-rate freezing 후 -196℃ 액체질소에 보존되었다가 paclitaxel (625 mg/m2), cisplatin (165 mg/ m2), cyclophosphamide (5,625 mg/m2)으로 이루어진 고용량 화학요법 후 다시 환자에게 이식되었다. 본 시술의 평가를 위하여 CEPRATEⓡ System의 CD34+ 조혈모세포 분리효율(%) 및 조혈기능 회복까지의 기간, 그리고 이식 후 합병증을 포함한 현시점까지의 경과를 분석하였다. 결과:각 환자 당 CD34+ 조혈모세포의 분리효율의 분포는 53~90%로 그 중앙값은 74%이었다 이식 후 화학요법과 관련된 부작용으로는 오심 및 구토, 점막염, 중추 및 말초 신경계 증상들이 전례에서 관찰되었고, 한 환자에서는 흡인성 폐렴으로 사망하였다. 그리고, 이식 후 7명의 환자들에서 저과립구성 발열이 발생하였으며, 그 기간의 중앙값은 4일(범위; 2~7일)이었다. 이식 후 과립구 수가 500/μL 및 2,000/μL 이상으로 회복되는 데 걸리는 기간의 중앙값은 각각 11일(범위; 9~17일), 23일(범위; 15~38일)이었고 혈소판 수가 20,000/μL 및 50,000/μL 이상으로 회복되는데 소요된 기간의 중앙값은 각각 15일(범위; 12~23일), 18일(범위; 14~35일)이었다 흡인성 폐렴으로 사망한 1명을 제외한 7명에서의 추적기간의 중앙값은 7 개월(범위; 3~35개월)이었다. 이 중 이식시 완전관해였던 환자가 3명, 부분관해였던 환자가 4명이었고, 부분관해 환자들 중 1명에서는 이식 후 완전관해로 호전이 되었다. 그러나 본 환자들 모두에서 이식 후 2-36+ 개월에 재발 혹은 진행 소견을 보이면서 이식 후 3-37+ 개월에 사망하였다. 결론:본 연구를 통하여 anthracycline을 포함한 기존의 항암제 치료 후 재발한 불량한 예후인자들을 지닌 환자들을 대상으로 한 고용량 paclitaxel 화학요법 후 CD34+ 조혈모세포이식은 기존의 고용량 화학요법 후 자가 조혈모세포이식의 성적과 차이가 없었음을 알 수 있었지만, 비교적 안전하게 우리나라의 환자들에서도 적용될 수 있다는 사실을 본 연구를 통하여 확인할 수 있었다. 그러므로, 본 연구를 기초로 하여 고용량 화학요법으로 치료효과를 극대화시킬 수 있는 예후인자들을 지닌 재발성 전이성 유방암 환자들을 대상으로 한 추가 연구가 필요하리라고 사료된다. Background: Autologous hematopoietic stem cell transplantation using a positive purging method to detect CD34+ cells has a benefit of having a less chance of contamination with cancer cells in the transplanted blood containing stem cells than that using a negative purging method. And, paclitaxel is approved to be a new effective chemotherapeutic agent for breast cancer. So, the clinical results of the CD34+ hematopoietic stem cell transplantation with high-dose paclitaxel chemotherapy in the recurred metastatic breast carcinoma patients have been reported in this study. Methods: 8 patients (woman, median age: 40 years, range; 32~59 years) with metastatic (liver, bone, lymph nodes) breast carcinoma recurred after the treatment of curative operation and adjuvant CAF (cyclophosphamide, adriamycin, 5-FU) chemotherapy, have been enrolled in this study. All patients had been responded to 4 cycles of paclitaxel (175 mg/m2) and ifosfamide (1,800 mg/m2) chemotherapy. CD34+ hematopoietic stem cells were purified from bone marrow blood by CEPRATEⓡ SC Stem Cell Concentration System using avidin-coated polyacrylamide beads column. The high-dose chemotherapy regimen was consisted with paclitaxel (625 mg/m2), cisplatin (165 mg/m2), and cyclophosphamide (5,625 mg/m2). The separation yield of CD34+ hematopietic stem cells, the hematopoietic recovery time, and the clinical outcomes of transplantation have been evaluated in this study. Results: The separation yield of CD34+ hematopietic stem cells with CEPRATEⓡ SC Stem Cell Concentration System was ranged from 53~90% (median: 74%). All patients had been experienced nausea with vomiting, mucositis, central or peripheral neuropathy after high-dose paclitaxel chemotherapy. One patient had been expired due to aspiration pneumonitis. Neutropenic fever was developed in seven patients with the duration of 2~7 (median: 4) days. The median (range) duration of neutrophil recovery to 500/μL and 2,000/μL was 11 (9~17) and 23 (15~38) days, respectively. The median (range) duration of platelet recovery to 20,000/μL and 50,000/μL was 15 (12~23) and 18 (14~35) days, respectively. The median follow-up duration after transplantation was 7 (3~37) months. All patients experienced disease relapse or progression after 2-36+ months after transplantation. Therefore, overall rate of 3 year disease free survival in this study was 14.3 (1/7)%. Conclusion:CD34+ hematopoietic stem cell transplantation with high-dose paclitaxel chemotherapy in the recurred metastatic breast carcinoma patients seems to have no superior clinical outcome compared to the other modalities of high-dose chemotherapy with hematopoietic stem cell transplantation. But, we can find that high-dose paclitaxel (625 mg/m2, dose ratio; 3.57) therapy is relatively safe in Korean patients. Therefore, further studies targeted to the recurred metastatic breast cancer patients with moderate to good prognostic factors will be warranted.

조혈모세포이식 시 조기생착에 영향을 주는 요인 분석 -경구섭취 저해인자 및 영양지원 시기를 중심으로-

김혜진 ( Hye Jin Kim ),노민영 ( Min Young Noh ),정명지 ( Myeong Ji Jung ),홍정임 ( Jeong Im Hong ),정연선 ( Yeon Sun Jung ) 대한영양사협회 2009 대한영양사협회 학술지 Vol.15 No.2

Hematopoietic stem cell transplantation is being widely used in an attempt to treat many hematological diseases such as leukemia, anemia, and lymphoma. To evaluate the success of hematopoietic stem cell transplantation, it is very important to determine how rapidly engraftment occurs. Therefore, this retrospective study was conducted to determine which factors affected the term of engraftment during hematopoietic stem cell transplantation, while focusing on the oral intake status. To accomplish this, 416 patients who underwent transplant operations at St. Mary`s hospital from May 2006 to April 2008 were evaluated. The long-term engraftment group was characterized as having longer fasting days and more frequent vomiting, diarrhea, and oral mucositis incidences than the short-term engraftment group. In addition, the inhibitors of oral intake such as vomiting, diarrhea, and oral mucositis developed frequently between the pre-transplantation and 2 weeks after transplantation. A significantly negative correlation was observed between the oral intake volume and the duration of the oral intake inhibitors. A multiple regression analysis revealed that the frequency of vomiting and oral mucositis during hematopoietic stem cell transplantation, the length of hospitalization, and the hematocrit level in the 2 weeks after hematopoietic stem cell transplantation were significant predictors of engraftment. The results of this study could be used to establish a guideline for nutritional assessment, nutritional goals, and nutritional support for patients during hematopoietic stem cell transplantation.

사람의 동종 조혈모세포이식에서 CD4+CD25+ T세포의 분포와 이식편대숙주병

이대형,정낙균,정대철,김학기,조빈 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.12

Purpose:This study aimed to determine the frequencies of CD4+CD25+ T cells in donor graft and peripheral blood CD4+CD25+ T cells in recipients after hematopoietic stem cell transplantation (HSCT) and their association with graft-versus-host disease (GVHD). Methods:Seventeen children who underwent HSCT were investigated. CD4+CD25+ T cells in samples from donor grafts and recipient peripheral blood were assessed by flow cytometry at 1 and 3 months after transplantation. Results:CD4+CD25+ T cell frequencies in the grafts showed no significant difference between patients with and without acute GVHD (0.90% vs. 1.06%, P=0.62). Absolute CD4+CD25+ T cell number in grafts were lower in patients with acute GVHD than in those without acute GVHD (6.18×105/kg vs. 25.85×105/kg, P=0.09). Patients without acute GVHD showed a significant decrease in peripheral blood CD4+CD25+ T cell percentage at 3 months compared to those at 1 month after HSCT (2.11% vs. 1.43%, P=0.028). However, in patients with acute GVHD, CD4+CD25+ T cell percentage at 3 months was not different from the corresponding percentage at 1 month after HSCT (2.47% vs. 2.30%, P=0.5). Conclusion:The effect of frequencies of CD4+CD25+ T cells in donor grafts on acute GVHD after HSCT could not be identified, and the majority of peripheral blood CD4+CD25+ T cells in patients who underwent HSCT may be activated T cells related to acute GVHD rather than regulatory T cells. Further studies with additional markers for regulatory T cells are needed to validate our results. (Korean J Pediatr 2008;51:1336-1341) Purpose:This study aimed to determine the frequencies of CD4+CD25+ T cells in donor graft and peripheral blood CD4+CD25+ T cells in recipients after hematopoietic stem cell transplantation (HSCT) and their association with graft-versus-host disease (GVHD). Methods:Seventeen children who underwent HSCT were investigated. CD4+CD25+ T cells in samples from donor grafts and recipient peripheral blood were assessed by flow cytometry at 1 and 3 months after transplantation. Results:CD4+CD25+ T cell frequencies in the grafts showed no significant difference between patients with and without acute GVHD (0.90% vs. 1.06%, P=0.62). Absolute CD4+CD25+ T cell number in grafts were lower in patients with acute GVHD than in those without acute GVHD (6.18×105/kg vs. 25.85×105/kg, P=0.09). Patients without acute GVHD showed a significant decrease in peripheral blood CD4+CD25+ T cell percentage at 3 months compared to those at 1 month after HSCT (2.11% vs. 1.43%, P=0.028). However, in patients with acute GVHD, CD4+CD25+ T cell percentage at 3 months was not different from the corresponding percentage at 1 month after HSCT (2.47% vs. 2.30%, P=0.5). Conclusion:The effect of frequencies of CD4+CD25+ T cells in donor grafts on acute GVHD after HSCT could not be identified, and the majority of peripheral blood CD4+CD25+ T cells in patients who underwent HSCT may be activated T cells related to acute GVHD rather than regulatory T cells. Further studies with additional markers for regulatory T cells are needed to validate our results. (Korean J Pediatr 2008;51:1336-1341)

Co-transplantation of Human Mesenchymal Stem Cells Promotes Human CD34+ Cells Engraftment in a Dose-dependent Fashion in NOD/SCID Mice

Park, Seong-Kyu,Won, Jong-Ho,Kim, Hyun-Jung,Bae, Sang-Byung,Kim, Chan-Kyu,Lee, Kyu-Taeg,Lee, Nam-Su,Lee, You Kyoung,Jeong, Dae-Chul,Chung, Nak-Gyun,Kim, Hyun-Soo,Hong, Dae-Sik,Park, Hee-Sook The Korean Academy of Medical Sciences 2007 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.22 No.3

<P>Mesenchymal stem cells (MSCs) have recently been identified and characterized in humans. Moreover, MSC secrete cytokines that can support hematopoietic progenitor growth. In the present study, we evaluated whether the efficacy of hematopoietic stem cell transplantation is improved by their co-transplantation with MSC, and whether this is positively correlated with the dose of infused MSCs. Accordingly, irradiated NOD/SCID mice were transplanted with 1×10<SUP>5</SUP> human CD34+ cells in the presence or absence of culture expanded MSCs (1×10<SUP>6</SUP> or 5×10<SUP>6</SUP>). We evaluated human hematopoietic cell engraftment by flow cytometry and assessed MSC tissue distributions by fluorescence in situ hybridization. We found that CD45+ and CD34+ cell levels were significantly elevated in a dose-dependent manner in cotransplanted mice 4 weeks after transplantation. The engraftments of CD33+ and CD19+ cells also increased dose-dependently. However, the engraftment of CD3+ cells did not increase after co-transplantation with MSCs. Human Y chromosome+ cells were observed in multiple tissues and were more frequently observed in mice co-transplanted with 5×10<SUP>6</SUP> rather than 1×10<SUP>6</SUP> MSCs. These results suggest that MSCs are capable of enhancing hematopoietic cell engraftment and distribution in multiple organs in a dose-dependent fashion.</P>

Recent advances in haploidentical hematopoietic stem cell transplantation using ex vivo T cell-depleted graft in children and adolescents

Ho Joon Im,Kyung-Nam Koh,Jong Jin Seo 대한혈액학회 2016 Blood Research Vol.51 No.1

Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment for chil-dren and adolescents with various malignant and non-malignant diseases. While human leukocyte antigen (HLA)-identical sibling donor is the preferred choice, matched un-related volunteer donor is another realistic option for successful HSCT. Unfortunately, it is not always possible to find a HLA-matched donor for patients requiring HSCT, leading to a considerable number of deaths of patients without undergoing transplantation. Alternatively, allogeneic HSCT from haploidentical family members could provide donors for virtually all patients who need HSCT. Although the early attempts at allogeneic HSCT from haploidentical family donor (HFD) were disappointing, recent advances in the effec-tive ex vivo depletion of T cells or unmanipulated in vivo regulation of T cells, better suppor-tive care, and optimal conditioning regimens have significantly improved the outcomes of haploidentical HSCT. The ex vivo techniques used to remove T cells have evolved from the selection of CD34+ hematopoietic stem cell progenitors to the depletion of CD3+cells, and more recently to the depletion of + T cells. The recent emerging evidence for ex vivo T cell-depleted haploidentical HSCT has provided additional therapeutic op-tions for pediatric patients with diseases curable by HSCT but has not found a suitable related or unrelated donor. This review discusses recent advances in haploidentical HSCT, focusing on transplant using ex vivo T cell-depleted grafts. In addition, our experiences with this novel approach for the treatment of pediatric patients with malignant and non-malignant diseases are described.

조혈모세포 이식 후 발생한 자가면역성 용혈성빈혈 1예

채효진,김용구,김명신,임지향,한경자,조석구,이종욱 대한진단검사의학회 2008 Annals of Laboratory Medicine Vol.28 No.1

A 32-yr-old male diagnosed with myelodysplastic syndrome underwent an unmanipulated, unrelated, HLA matched, peripheral blood stem cell transplantation. The patient and donor were both blood type O, CcDEe. Twelve weeks post-transplantation, he developed acute autoimmune hemolytic anemia (AIHA). He was transfused multiple times with washed O red cells. High-dose steroid therapy was initiated and he underwent splenectomy; however, AIHA was refractory to therapy. The patient was further treated with combined treatment modalities including immunosuppressive therapy with mycophenolate mofetil and cyclosporine and three cycles of plasma exchange, and AIHA responded to treatment. This is the third case of AIHA complicating hematopoietic stem cell transplantation reported in Korea. Since AIHA is relatively common after hematopoietic stem cell transplantation, accurate and timely diagnosis of the disease and treatment strategies with multiple modalities are necessary. (Korean J Lab Med 2008;28:64-9)

소아 동종 조혈모세포이식 200예의 분석 : Single Center Study

김학기,조빈,정낙균,정대철,장필상,김선영,김춘추 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

연구배경: 1983년 11월부터 2000년 9월까지 시행한 동종 조혈모세포이식의 성적을 분석하여 소아 골수이식의 발전 방향을 모색하고자 하였다. 방법: 1983년 11월부터 2000년 9월까지 가톨릭의대 조혈모세포이식센터, 성모병원 소아과에서 동종 조혈모세포이식을 시행한 200예를 대상으로 조혈모세포이식의 유형 및 대상질환, 이식 당시의 상태 및 전처치에 따른 치료 성적을 후향적으로 분석하였다. 결과: 200예 중 HLA-일치 형제간 골수이식이 146예(73%), HLA-일치 형제간 골수이식 이외의 이식이 54예(27%)였다. 1) HLA-일치 형제간 골수이식: 146예 중 남아와 여아가 각각 78명과 68명이었으며 SAA 50예의 5년 무병 생존율은 95.8±2.9%였고 AML 45예의 5년 무병 생존율은 71.7±7.0%로 일차 및 이차 관해기에 이식 받은 40예와 5예의 5년 무병 생존율은 각각 73.6±7.2%와 60.0±21.9%였다. AML에서 전처치로 Bu/Cy를 사용한 28예와 TBI/Cy를 사용하였던 9예의 5년 무병 생존율은 각각 81.9±7.4%와 33.3±15.7%였으며 Bu/Cu/TBI를 시행한 8예의 무병 생존율은 80.0±17.9%였다. ALL 33예의 5년 이상 무병 생존율은 75.5±7.5%였고 일차 및 이차 관해기에 이식을 시행하였던 18예와 14예의 무병 생존율은 각각 83.0±9.0%와 71.4±12.1%였다. CML 및 MDS 11예의 5년 무병 생존율은 72.7±13.4%였다. 기타 질환으로는 Fanconi 빈혈 2예, 혈구탐식성 조직구증식증 2예, 순적혈구 빈혈 2예, Kostmann 증후군이 1예로 이들의 전체 무병 생존율은 85.7±13.2%였다. 2) HLA-일치 형제간 골수이식 이외의 이식을 시행하였던 54예의 3년 이상 무병 생존율은 45.3±11.6%였으며 HLA-일치 UBMT 26예, CBSCT 15예, 형제 이외의 혈연에 의한 골수이식이 13예로 이들의 무병 생존율은 각각 56.2±10.8%, 58.2±13.1%, 35.9±17.3%였다. 결론: 소아 난치성 혈액질환의 완치요법으로 동종 골수이식의 치료효과를 확인할 수 있었으며, 동종 조혈모세포의 공여원으로 비혈연간 골수나 제대혈의 이용이 점차 증가하고 있음을 알 수 있었다. Background: Bone marrow transplantation was first introduced to Korean children in 1983. Since then the number of children receiving transplants has increased steadily. Methods: We analyzed two hundred pediatric cases of allogeneic hematopoietic stem cell transplantation between Nov. 1983 and Sep. 2000 in Catholic Hematopoietic Stem Cell Transplantation Center of Korea. Results: HLA-matched sibling transplantations were performed in 146 cases (78 males, 68 females, median age; 10 years) with median follow-up of 47 months. The 3-year estimated event-free survival (EFS) of ALL and AML was 76% and 72% respectively. The 5-year estimated EFS of severe aplastic anemia and CML/MDS was 96% and 73% respectively. The 2-year estimated EFS of nonmalignant rare disease was 86%. Twenty-six children underwent unrelated bone marrow transplantation (UBMT), 15 cord blood stem cell transplanta-tion (CBSCT) and 13 familial haploidentical transplantation (FHT). There were 35 males and 19 females with a median age of 6.5 years and median follow-up of 18.5 months. The estimated 2-year EFS of UBMT, CBSCT and FHT were 56%, 58% and 34% respectively. Conclusion: HLA-matched sibling allogeneic BMT showed better survival in children with hematopoietic stem cell disorder compared to UBMT and CBSCT. Recently, transplants using alternative stem cell source are increasing due to lack of suitable matched sibling donor and continuous efforts for reducing transplant-related complications are warranted for improving survival.

Recent advances in haploidentical hematopoietic stem cell transplantation using ex vivo T cell-depleted graft in children and adolescents

Ho Joon Im,Kyung-Nam Koh,Jong Jin Seo 대한혈액학회 2016 Blood Research Vol.51 No.1

Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment for chil-dren and adolescents with various malignant and non-malignant diseases. While human leukocyte antigen (HLA)-identical sibling donor is the preferred choice, matched un-related volunteer donor is another realistic option for successful HSCT. Unfortunately, it is not always possible to find a HLA-matched donor for patients requiring HSCT, leading to a considerable number of deaths of patients without undergoing transplantation. Alternatively, allogeneic HSCT from haploidentical family members could provide donors for virtually all patients who need HSCT. Although the early attempts at allogeneic HSCT from haploidentical family donor (HFD) were disappointing, recent advances in the effec-tive ex vivo depletion of T cells or unmanipulated in vivo regulation of T cells, better suppor-tive care, and optimal conditioning regimens have significantly improved the outcomes of haploidentical HSCT. The ex vivo techniques used to remove T cells have evolved from the selection of CD34+ hematopoietic stem cell progenitors to the depletion of CD3+cells, and more recently to the depletion of + T cells. The recent emerging evidence for ex vivo T cell-depleted haploidentical HSCT has provided additional therapeutic op-tions for pediatric patients with diseases curable by HSCT but has not found a suitable related or unrelated donor. This review discusses recent advances in haploidentical HSCT, focusing on transplant using ex vivo T cell-depleted grafts. In addition, our experiences with this novel approach for the treatment of pediatric patients with malignant and non-malignant diseases are described.

Nutritional Intake and Nutritional Status by the Type of Hematopoietic Stem Cell Transplantation

( Eun Jin So ),( Ji Sun Lee ),( Jee Yeon Kim ) 한국임상영양학회 2012 Clinical Nutrition Research Vol.1 No.1

The aim of this study was to investigate the changes of nutritional intake and nutritional status and analyze the association between them during hematopoietic stem cell transplantation. This was a retrospective cross sectional study on 36 patients (9 Autologous transplantation group and 27 Allogeneic transplantation group) undergoing hematopoietic stem cell transplantation at The Catholic University of Korea, Seoul St. Mary``s Hospital from May to August 2010. To assess oral intake and parenteral nutrition intake, 24-hour recall method and patient``s charts review was performed. Nutritional status was measured with the scored patient-generated subjective global assessment (PG-SGA). The subjects consisted of 6 (66.7%) males and 3 (33.3%) females in the autologous transplantation group (auto), 12 (44.4%) males and 15 (55.6%) females in the allogeneic transplantation group (allo). The mean age was 40.9 ± 13.6 years (auto) and 37.8 ± 11.0 years (allo). The average hospitalized period was 25.2 ± 3.5 days (auto) and 31.6 ± 6.6 days (allo), which were significant different (p < 0.05). Nutritional intake was lowest at Post+1wk in two groups. In addition, calorie intake by oral diet to recommended intake at Post+2wk was low (20.8% auto and 20.5% allo) but there were no significant differences in change of nutritional intake over time (Admission, Pre-1day, Post+1wk, Post+2wk) between auto group and allo group by repeated measures ANOVA test. The result of nutritional assessment through PG-SGA was significantly different at Pre-1day only (p < 0.01). There was a significant negative correlation between the nutritional status during Post+2wk and the oral calorie/protein intake to recommended amount measured during Post+1wk and Post+2wk (p < 0.01). These results could be used to establish evidence-based nutritional care guidelines for patients during hematopoietic stem cell transplantation.

Effects of Korean red ginseng on T-cell repopulation after autologous hematopoietic stem cell transplantation in childhood cancer patients

Kyung Taek Hong,Yeon Jun Kang,Jung Yoon Choi,Young Ju Yun,Il-Moo Chang,Hee Young Shin,Hyoung Jin Kang,Won-Woo Lee 고려인삼학회 2024 Journal of Ginseng Research Vol.48 No.1

Background: Although the survival outcomes of childhood cancer patients have improved, childhood cancersurvivors suffer from various degrees of immune dysfunction or delayed immune reconstitution. This studyaimed to investigate the effect of Korean Red Ginseng (KRG) on T cell recovery in childhood cancer patients whounderwent autologous hematopoietic stem cell transplantation (ASCT) from the perspective of inflammatory andsenescent phenotypes. Methods: This was a single-arm exploratory trial. The KRG group (n = 15) received KRG powder from month 1 tomonth 12 post-ASCT. We compared the results of the KRG group with those of the control group (n = 23). Theproportions of T cell populations, senescent phenotypes, and cytokine production profiles were analyzed at 1, 3,6, and 12 months post-ASCT using peripheral blood samples. Results: All patients in the KRG group completed the treatment without any safety issues and showed a comparableT cell repopulation pattern to that in the control group. In particular, KRG administration influenced therepopulation of CD4+ T cells via T cell expansion and differentiation into effector memory cell re-expressingCD45RA (EMRA) cells. Although the KRG group showed an increase in the number of CD4+ EMRA cells, theexpression of senescent and exhausted markers in these cells decreased, and the capacity for senescence-relatedcytokine production in the senescent CD28- subset was ameliorated. Conclusions: These findings suggest that KRG promotes the repopulation of CD4+ EMRA T cells and regulatesphenotypical and functional senescent changes after ASCT in pediatric patients with cancer.