Immunoregulatory Mechanisms Involving GvL Effect

Gournay V, Vallet N, Peux V, et al. Immune Landscape After Allo-HSCT: TIGIT and CD161-Expressing CD4 T Cells Are Associated with Subsequent Leukemia Relapse. Blood. 2022; (doi: 10.1182/blood.2022015522).

Relapse is the primary cause of death in acute myeloid leukemia (AML) patients who undergo allogeneic hematopoietic stem cell transplantation (allo-HSCT), and researchers believe post-procedure changes to the immune landscape predict who is most vulnerable. Investigators assessed two cohorts of patients after allo-HSCT and a sample of healthy individuals as the comparator group. Investigators found that variations in the immune landscape are common 6–12 months following allo-HSTC, but the environment up to that point is generally stable. Elevated expression of TIGIT and CD161 on CD4 T cells during the first few months after transplantation is associated with greater likelihood for relapse. This new insight could lay the foundation for novel prognostic tools, the study authors said. Additionally, it could identify new therapeutic targets to restore the graft-versus-leukemia (GvL) effect — which normally inhibits tumor cell growth after allo-HSCT but may be disrupted by certain immunoregulatory mechanisms.

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Tags: AML, patient care, Relapse, cell therapy, CART, allogeneic stem cell transplantation, CD4, Allo-HSCT, acute myeloid leukemia