Pre-transplant donor CD4 invariant NKT cell expansion capacity predicts the occurrence of acute graft-versus-host disease.
Fiche publication
Date publication
avril 2017
Journal
Leukemia
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RUBIO Marie Thérèse
Tous les auteurs :
Rubio MT, Bouillié M, Bouazza N, Coman T, Trebeden-Nègre H, Gomez A, Suarez F, Sibon D, Brignier A, Paubelle E, Nguyen-Khoc S, Cavazzana M, Lantz O, Mohty M, Urien S, Hermine O
Lien Pubmed
Résumé
Clinically useful pre-transplant predictive factors of acute graft-versus-host-disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-SCT) are lacking. We prospectively analyzed HSC graft content in CD34, NK, conventional T, regulatory T and invariant natural killer T (iNKT) cells in 117 adult patients before allo-SCT. Results were correlated with occurrence of aGVHD and relapse. In univariate analysis, iNKT cells were the only graft cell populations associated with occurrence of aGVHD. In multivariate analysis, CD4 iNKT/T cell frequency could predict grade II-IV aGVHD in bone marrow and peripheral blood stem cell (PBSC) grafts, while CD4 iNKT expansion capacity was predictive in PBSC grafts. Receiver operating characteristic analyses determined the CD4 iNKT expansion factor as the best predictive factor of aGVHD. Incidence of grade II-IV aGVHD was reduced in patients receiving a graft with an expansion factor above versus below 6.83 (9.7 vs 80%, P<0.0001), while relapse incidence at two years was similar (P=0.5).The test reached 94% sensitivity and 100% specificity in the subgroup of patients transplanted with human leukocyte antigen 10/10 PBSCs without active disease. Analysis of this CD4 iNKT expansion capacity test may represent the first diagnostic tool allowing selection of the best donor to avoid severe aGVHD with preserved graft-versus-leukemia effect after peripheral blood allo-SCT.
Mots clés
Acute Disease, Female, Graft vs Host Disease, diagnosis, Hematopoietic Stem Cell Transplantation, adverse effects, Humans, Male, Natural Killer T-Cells, immunology, Preoperative Period, Prognosis, Severity of Illness Index, Tissue Donors, Transplantation, Homologous
Référence
Leukemia. 2017 Apr;31(4):903-912