title: Persistent donor derived Vδ4 T cell clones may improve survival for recurrent T cell acute lymphoblastic leukemia after HSCT and DLI.
abstract: The outcome for T-cell acute lymphoblastic leukemia (T-ALL) in relapse after hematopoietic stem cell transplantation (HSCT) is quite poor, while, both donor lymphocytes infusion (DLI) and adoptively infusion of γδ T cells in leukemia patients after HSCT have demonstrated good results in prolonging survival time of patients. Here, we reported a T-ALL case who experienced three relapses and received HSCT and DLI with an overall survival (OS) time lasting for more than seven years. Based on our previous identification of a leukemic and reactive clone in this patient, continual γδ T cell repertoire monitoring affirmed that the same Vδ5 leukemic clone existed in most samples from the patient, particularly including a sample taken at the time of the third T-ALL relapse, while it could not be detected in the donor sample. In addition, an identical Vδ4 monoclonal T cell that proliferated in the recipient for several years was confirmed to come from the donor graft, and its expression level significantly increased in third leukemia recurrence. These results indicate that clonally expanded Vδ4 T cells may represent a reconstituted γδ T cell repertoire after HSCT, which also hints to a relatively better outcome for this case. Based on this case study, we recommend DLI should be as a treatment strategy for patients who achieve CR or relapse from HSCT. Moreover, dynamically monitoring the TCR repertoire in patients who receive HSCT will benefit in supervising of malignant clone evolution and residue, identifying T cell clones mediate anti-infection, GvHD or GvL.
authors.affiliation: Institute of Hematology, Jinan University, Guangzhou, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Jianyu
authors.initials: J
authors.lastname: Weng
authors.affiliation: Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.affiliation: Institute of Hematology, Jinan University, Guangzhou, China.
authors.forename: Chengwu
authors.initials: C
authors.lastname: Zeng
authors.affiliation: Institute of Hematology, Jinan University, Guangzhou, China.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Suxia
authors.initials: S
authors.lastname: Geng
authors.affiliation: Institute of Hematology, Jinan University, Guangzhou, China.
authors.forename: Lijian
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Suijing
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, Florida, USA.
authors.forename: Suming
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Hematology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.affiliation: Institute of Hematology, Jinan University, Guangzhou, China.|Key Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, China.|Department of Hematology, First Affiliated Hospital, Jinan University, Guangzhou, China.
authors.forename: Yangqiu
authors.initials: Y
authors.lastname: Li
mesh_terms: D001782:Blood Donors; D002999:Clone Cells / Q000276:immunology / Q000378:metabolism; D015870:Gene Expression / Q000276:immunology; D006086:Graft vs Host Disease / Q000209:etiology / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods; D017710:Lymphocyte Transfusion / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D016019:Survival Analysis; D013601:T-Lymphocytes / Q000276:immunology* / Q000378:metabolism / Q000637:transplantation; D016896:Treatment Outcome
chemical_list: D016692:Receptors, Antigen, T-Cell, gamma-delta
keywords: DLI; Immune response; Immunity; Immunology and Microbiology Section; MRD; T cell repertoire; T-ALL; allo-HSCT