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Improved Overall Survival, Relapse-Free-Survival, and Less Graft-vs.-Host-Disease in Patients With High Immune Reconstitution of TCR Gamma Delta Cells 2 Months After Allogeneic Stem Cell Transplantation.
- Source :
-
Frontiers in immunology [Front Immunol] 2019 Aug 22; Vol. 10, pp. 1997. Date of Electronic Publication: 2019 Aug 22 (Print Publication: 2019). - Publication Year :
- 2019
-
Abstract
- T-cell receptor (TCR) γδ cells are perceived as innate-like effector cells with the possibility of mediating graft-vs. -tumor (GVT) without causing graft-vs.-host disease (GVHD) in the setting of hematopoietic allogeneic stem cell transplantation (HSCT). We conducted a prospective study to assess the clinical impact of TCR γδ cell immune reconstitution on overall survival, relapse-free-survival, relapse and GVHD. The impact of CD3, CD4, and CD8 T cells together with NK cells including subtypes were analyzed in parallel. A total of 108 patients with hematological malignancies transplanted with HLA-matched, T cell replete stem cell grafts were included for analyses of absolute concentrations of CD3, CD4, and CD8 positive T cells and NK cells together with a multi-color flow cytometry panel with staining for TCRαβ, TCRγδ, Vδ1, Vδ2, CD3, CD4, CD8, HLA-DR, CD196, CD45RO, CD45RA, CD16, CD56, CD337, and CD314 at 28, 56, 91, 180, and 365 days after transplantation. Immune reconstitution data including subsets and differentiation markers of T and NK cells during the first year after transplantation was provided. Patients with TCR γδ cell concentrations above the median value of 21 (0-416) × 10 <superscript>6</superscript> cells/L 56 days after transplantation had significantly improved overall survival ( p = 0.001) and relapse-free survival ( p = 0.007) compared to patients with concentrations below this value. When day 56 cell subset concentrations were included as continuous variables, TCR γδ cells were the only T cell subsets with a significant impact on OS and RFS; the impact of TCR γδ cells remained statistically significant in multivariate analyses adjusted for pre-transplant risk factors. The risk of death from relapse was significantly decreased in patients with high concentrations of TCR γδ cells 56 days after transplantation ( p = 0.003). Also, the risk of acute GVHD was significantly lower in patients with day 28 TCR γδ cell concentrations above the median of 18 × 10 <superscript>6</superscript> cells/L compared to patients with low concentrations ( p = 0.01). These results suggest a protective role of TCR γδ cells in relapse and GVHD and encourage further research in developing adaptive TCR γδ cell therapy for improving outcomes after HSCT.
- Subjects :
- Adult
Aged
Female
Graft vs Host Disease diagnosis
Graft vs Host Disease mortality
Hematopoietic Stem Cell Transplantation methods
Humans
Immunity, Innate
Immunophenotyping
Male
Middle Aged
Transplantation Conditioning
Transplantation Immunology
Transplantation, Homologous
Young Adult
Graft vs Host Disease etiology
Graft vs Host Disease metabolism
Hematopoietic Stem Cell Transplantation adverse effects
Immune Reconstitution
Receptors, Antigen, T-Cell, gamma-delta metabolism
T-Lymphocyte Subsets immunology
T-Lymphocyte Subsets metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1664-3224
- Volume :
- 10
- Database :
- MEDLINE
- Journal :
- Frontiers in immunology
- Publication Type :
- Academic Journal
- Accession number :
- 31507601
- Full Text :
- https://doi.org/10.3389/fimmu.2019.01997