Selective T-cell depletion targeting CD45RA reduces viremia and enhances early T-cell recovery compared to CD3-targeted T-cell depletion

Abstract

Background

T-cell depletion (TCD) effectively reduces severe graft-versus-host disease in recipients of HLA-mismatched allografts. However, TCD is associated with delayed immune recovery and increased infections. We hypothesized that specific depletion of CD45RA+ naïve T cells, rather than broad depletion of CD3+ T cells, can preserve memory-immunity in the allografts, and confer protection against important viral infections in the early post-transplant period.

Methods

Sixty-seven patients who received TCD haploidentical donor transplantation for hematologic malignancy on three consecutive trials were analyzed.

Results

Patients receiving CD45RA-depleted donor grafts had 2000-fold more donor T cells infused, significantly higher T-cell counts at Day +30 post transplant (550/μL vs 10/μL; P< .001), and higher T-cell diversity by Vbeta spectratyping at Day +100 (P < .001). Importantly these recipients experienced a significant reduction in both the incidence (P = .002) and duration (P = .02) of any viremia (cytomegalovirus, Epstein-Barr virus, or adenovirus) in the first 6 months post transplant. Specifically, recipients of CD3-depleted grafts were more likely to experience adenovirus viremia (27% vs 4%, P = .02).

Conclusion

CD45RA-depletion provided a large number of donor memory T cells to the recipients, and was associated with enhanced early T-cell recovery and protection against viremia.

This article is protected by copyright. All rights reserved.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2Ac7hGY
via IFTTT