Unconventional T Cells Influence Clinical Outcome After Allogeneic Hematopoietic Cell Transplantation

J Clin Immunol. 2024 Jun 1;44(6):139. doi: 10.1007/s10875-024-01741-6.

Abstract

We evaluated the impact of early recovery of mucosal-associated invariant T cells (MAIT) and gamma-delta (γδ) T cells, especially Vδ2+ T cells, on the clinical outcomes of 76 patients who underwent allogeneic hematopoietic cell transplantation (allo-HCT). MAIT cells were identified at day 20-30 post-transplant using flow cytometry and defined as CD3+ TCRVα7.2+CD161+. Two subsets of Vδ2+ T cells were analyzed according to the expression of CD26. The cytotoxicity profile of MAIT and Vδ2+ T cells was analyzed according to the intracellular expression of perforin and granzyme B, and intracellular IFN-γ was evaluated after in vitro activation. CD26+Vδ2+ T cells displayed higher intracellular levels of IFN-γ, whereas CD26- Vδ2+ T were found to be more cytotoxic. Moreover, MAIT cell frequency was correlated with the frequency of Vδ2+ T cells with a better correlation observed with Vδ2+CD26+ than with the Vδ2+CD26- T cell subset. By using the composite endpoint graft-versus-host disease (GvHD)-free, relapse-free survival (GRFS) as the primary endpoint, we found that patients with a higher MAIT cell frequency at day 20-30 after allo-HCT had a significantly increased GRFS and a better overall survival (OS) and disease-free survival (DFS). Moreover, patients with a low CD69 expression by MAIT cells had an increased cumulative incidence of grade 2-4 acute GvHD (aGvHD). These results suggest that MAIT cell reconstitution may provide mitigating effects early after allo-HCT depending on their activation markers and functional status. Patients with a high frequency of Vδ2+CD26+ T cells had a significantly higher GRFS, OS and DFS, but there was no impact on cumulative incidence of grade 2-4 aGVHD, non-relapse mortality and relapse. These results revealed that the impact of Vδ2+ T cells on the success of allo-HCT may vary according to the frequency of the CD26+ subset.

Keywords: Acute graft-versus-host disease; Allogeneic hematopoietic cell transplantation (allo-HCT); Mucosal-associated invariant T cells (MAIT); Vδ2+ T cells.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cytotoxicity, Immunologic
  • Dipeptidyl Peptidase 4 / metabolism
  • Female
  • Graft vs Host Disease* / etiology
  • Graft vs Host Disease* / immunology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Mucosal-Associated Invariant T Cells* / immunology
  • Receptors, Antigen, T-Cell, gamma-delta / metabolism
  • T-Lymphocyte Subsets / immunology
  • T-Lymphocyte Subsets / metabolism
  • Transplantation, Homologous*
  • Treatment Outcome
  • Young Adult

Substances

  • Receptors, Antigen, T-Cell, gamma-delta
  • Dipeptidyl Peptidase 4