Individualization of Hematopoietic Stem Cell Transplantation Using Alpha/Beta T-Cell Depletion

Autor: Emelie Rådestad, Mikael Sundin, Johan Törlén, Sarah Thunberg, Björn Önfelt, Per Ljungman, Emma Watz, Jonas Mattsson, Michael Uhlin
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Frontiers in Immunology, Vol 10 (2019)
Druh dokumentu: article
ISSN: 1664-3224
DOI: 10.3389/fimmu.2019.00189
Popis: Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with several potentially lethal complications. Higher levels of CD3+ T-cells in the graft have been associated with increased risk of graft-versus-host disease (GVHD), but also beneficial graft-versus-leukemia effect and reduced infections. To tackle post-transplant complications, donor lymphocyte infusions have been used but with an increased risk of GVHD. To reduce this risk, we performed depletion of αβ T-cells and treated 12 patients post-HSCT suffering from infections and/or poor immune reconstitution. The αβ T-cell depleted cell products were characterized by flow cytometry. The median log depletion of αβ T-cells was −4.3 and the median yield of γδ T-cells was 73.5%. The median CD34+ cell dose was 4.4 × 106/kg. All 12 patients were alive 3 months after infusion and after 1 year, two patients had died. No infusion-related side effects were reported and no severe acute GVHD (grade III-IV) developed in any patient post-infusion. Overall, 3 months after infusion 11 out of 12 patients had increased levels of platelets and/or granulocytes. In conclusion, we describe the use of αβ T-cell depleted products as stem cell boosters with encouraging results.
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