03.25.22

Naive T Cell Depletion Prevents Chronic Graft-Versus-Host Disease

 

In a recent study published in the Journal of Clinical Oncology, researchers from the Fred Hutchinson Cancer Research Center found that naive T cell (TN) depletion reduced chronic graft-versus-host disease (cGVHD) incidence. These findings were generated by evaluating three phase II clinical trials where TN-depleted peripheral blood stem-cell (PBSC) grafts were transplanted.

In approximately 30–60% of leukemia patients who receive allogeneic hematopoietic cell transplantation (HCT), cGVHD will occur and can lead to reduced overall survival (OS). Although PBSCs remain one of the most prevalent graft sources, cGVHD is more prevalent when using these cells. In mouse models, TN-depleted grafts reduce GVHD. Therefore, the authors sought to determine if depleting TN from PBSC grafts would reduce cGVHD in humans.

In this study, 138 acute leukemia patients received TN-depleted HLA-matched allo grafts. The main outcome of this analysis was cGVHD diagnosis, with secondary outcomes being graft failure, OS, relapse, non-relapse mortality (NRM), and aGVHD within one year. The authors found a low rate of cGVHD at 7% and grade III and IV acute GVHD (aGVHD) in 4% and 0% of patients respectively. At three years, the OS, cGVHD-free, relapse-free survival, relapse, and NRM were 77%, 68%, 23%, and 8%. These findings support the use of TN-depleted grafts for cGVHD reduction.

Reference:

Bleakley M, Sehgal A, Seropian S, et al. Naive T-Cell Depletion to Prevent Chronic Graft-Versus-Host Disease [published online ahead of print, 2022 Jan 10]. J Clin Oncol. 2022; JCO2101755.

https://doi.org/10.1200/JCO.21.01755

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