Larger number of invariant natural killer T cells in PBSC allografts correlates with improved GVHD-free and progression-free survival.

Abstract

We studied the impact of a set of immune cells contained within granulocyte colony-stimulating factor-mobilized peripheral blood stem cell grafts (naïve and memory T-cell subsets, B cells, regulatory T cells, invariant natural killer T cells [iNKTs], NK cells, and dendritic cell subsets) in patients (n = 80) undergoing allogeneic stem cell transplantation (SCT), using the composite end point of graft-versus-host disease (GVHD)-free and progression-free survival (GPFS) as the primary end point. We observed that GPFS incidences in patients receiving iNKT doses above and below the median were 49% vs 22%, respectively (P= .007). In multivariate analysis, the iNKT dose was the only parameter with a significant impact on GPFS (hazard ratio = 0.48; 95% confidence interval, 0.27-0.85;P= .01). The incidences of severe grade III to IV acute GVHD and National Institutes of Health grade 2 to 3 chronic GVHD (12% and 16%, respectively) were low and associated with the use of antithymocyte globulin in 91% of patients. No difference in GVHD incidence was reported according to the iNKT dose. In conclusion, a higher dose of iNKTs within the graft is associated with an improved GPFS. These data may pave the way for prospective and active interventions aiming to manipulate the graft content to improve allo-SCT outcome.

• Authors: Florent Malard, Myriam Labopin, Patrice Chevallier, Thierry Guillaume, Alix Duquesne, Fanny Rialland, Sophie Derenne, Pierre Peterlin, Anne-Gaelle Leauté, Eolia Brissot, Marc Gregoire, Philippe Moreau, Philippe Saas, Béatrice Gaugler, Mohamad Mohty
• Journal: Blood (Blood) Vol. 127 Issue 14 Pg. 1828-35 (Apr 07 2016) ISSN: 1528-0020 [Electronic] United States
• PMID: 26903546 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2016 by The American Society of Hematology.

Chemical References

• Antilymphocyte Serum

Topics

• Adolescent
• Adult
• Aged
• Allografts
• Antilymphocyte Serum (administration & dosage)
• Child
• Chronic Disease
• Disease-Free Survival
• Female
• Graft vs Host Disease (immunology, mortality, pathology, prevention & control)
• Humans
• Male
• Middle Aged
• Natural Killer T-Cells (immunology, pathology)
• Retrospective Studies
• Stem Cell Transplantation
• Survival Rate