van Halteren AGS, Suwandi J, Tuit S, et al. A Unique Immune Signature in Blood Separates Therapy-Refractory from Therapy-Responsive Acute Graft-Versus-Host Disease. Blood. 2022; (doi: 10.1182/blood.2022015734).

New research indicates that the onset of acute graft-versus-host disease (aGvHD) sets off lymphoid and myeloid compartments. The authors used mass cytometry to evaluate circulating myeloid and lymphoid cells in children with Grade III-IV aGvHD who received either immune suppressive drugs or immune suppressive drugs plus mesenchymal stromal cells. The appearance of CD11b+CD163+ myeloid cells in the blood and accumulation in the skin and gastrointestinal (GI) tract correlated with aGvHD onset. Also present in the blood samples were distinct T-cell populations, including TCRyd+ cells producing activation markers and chemokine receptors homing to the skin and GI tract. Proportionally high levels of effector and regulatory T-cells with skin/gut homing receptors were sustained in non-responding patients over time, while their levels declined in responders. There appears to be additive value of high dimensional immune cell profiling in determining clinical response. Researchers conclude that this approach may be helpful in making decisions in the management of severe aGvHD.

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Tags: patient care, GVHD, T-cells, response, Research, aGVHD, Severity, cell therapy, T-Cell, myeloid, t-cell therapy, activity, graft-versus-host