Persistent cytotoxic T lymphocyte expansions after allogeneic haematopoietic stem cell transplantation: kinetics, clinical impact and absence of STAT3 mutations

• DOI: 10.1111/bjh.13917
• Publication Date: 2016-01-05T14:15:06Z
• Authors: Julia Muñoz‐Balle...; Tzu H. Chen‐Liang; Ana M. Hurtado; Inmaculada Heras; Felipe de Arriba; María D. García‐Malo; Pastora Iniesta; María L. Lozano; José B. Nieto; Francisco J. Ortuño; María del M. Osma; José Padilla; Raúl Teruel‐Montoya; Vicente Vicente; Cristina Castilla...; Andrés Jerez
• Keywords: CTL*; Thymoglobulin

Peripheral expansion of cytotoxic T lymphocytes (CTL) derived from the graft in initial stages allogeneic haematopoietic stem cell transplantation (alloHSCT) immune recovery is a well-known physiological event. The description symptomatic large granular lymphocyte leukaemia this setting may generate uncertainty, mostly those cases which CTL (CTLe) persists beyond early period. We aimed to assess nature CTLe during post-alloHSCT period 154 adult patients with long-term surveillance. studied longitudinal kinetics expansions, their relationship clinical events, and phenotypic molecular features, including recently reported leukaemia-STAT3 mutations. Persistent relative are frequent (49%), related thymoglobulin prophylaxis (P ≤ 0·001), acute graft-versus-host disease (GVHD, P = 0·02), reduced intensity conditioning 0·04). Absolute scarce (9%) chronic GVHD. receptor rearrangement was as clonal oligoclonal majority CTLe. absence STAT3 mutations CD8/CD4 declining late supports its benign nature, expressed clinically by null detrimental impact these expansions on post-transplant outcome and/or serious infectious events.