Pre-transplant donor CD4− invariant NKT cell expansion capacity predicts the occurrence of acute graft-versus-host disease - Archive ouverte HAL Access content directly
Journal Articles Leukemia Year : 2016

Pre-transplant donor CD4− invariant NKT cell expansion capacity predicts the occurrence of acute graft-versus-host disease

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N Bouazza
  • Function : Author
S Nguyen-Khoc
  • Function : Author
O. Lantz
  • Function : Author
O. Hermine

Abstract

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.
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Dates and versions

hal-01777934 , version 1 (01-04-2022)

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Marie-Thérèse Rubio, M. Bouillié, N Bouazza, T. Coman, H Trebeden-Nègre, et al.. Pre-transplant donor CD4− invariant NKT cell expansion capacity predicts the occurrence of acute graft-versus-host disease. Leukemia, 2016, 31 (4), pp.903 - 912. ⟨10.1038/leu.2016.281⟩. ⟨hal-01777934⟩
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