Abstract
BackgroundGraft-versus-host disease (GVHD) is one of the most complex complications after allogeneic stem cell transplantation. Current standard of grading system is based on clinical symptoms in skin, liver and intestinal. However, it’s difficult to differ GVHD and its extent just by clinical manifestation. Here we retrospectively analyzed cell immune function in patients implemented allogeneic stem cell transplantation in Ningbo first Hospital from Jan 2013 to Jan 2018.Resultsthe data are collected from 51 patients (mean age was 42; 45.1% women). The average NK cell percentage was 39.31% in severe GVHD (Grade III-IV), was 16.98% in mild GVHD (GradeI-II), while was 21.15% in No GVHD group. The statistical analysis showed difference among each grade. Further analysis was performed in Antithymocyte globulin (ATG) treated group and control group. We showed NK Cell percentage was sharply different in ATG treated group: 47.34% in severe GVHD, 11.98% in mild GVHD group, while 18.3% in no GVHD group. However, in control group, the average percentage of NK cells was 23.27% in severe GVHD, was 23.22%in mild GVHD group, while was 21.13% in no GVHD group.ConclusionThe data supports that ATG can prevent GVHD by increasing NK cell percentage. The percentage of NK cell seemed to be a useful probe to evaluate the severity of GVHD in allogeneic stem cell transplantation patients using ATG in pretreatment.
Highlights
Graft-versus-host disease (GVHD) is one of the most complex complications after allogeneic stem cell transplantation
Conditioning regimen and transplant procedure Among HLA-matched sibling and 5 Aplastic anemia (AA) transplant recipients in the Antithymocyte globulin (ATG)-treated group, all patients received a small dose (2.5 mg/kg) of ATG in the conditioning regimen
Our study showed that ATG can prevent GVHD by increase NK cell percentage
Summary
Graft-versus-host disease (GVHD) is one of the most complex complications after allogeneic stem cell transplantation. Graft-versus-host disease (GVHD) poses as a major complication following allo-genetic hematopoietic stem cell transplantation (allo-HCT). Antithymocyte globulin (ATG) is a polyclonal antibody against fresh human thymocytes derived from rabbits, horses, or pigs It has been used as a T celldepleting agent in stem cell transplantation and organ transplantation, and has been found to decrease the incidence of GVHD [3]. A multicenter clinical trial investigated rabbit-derived ATG(rATG) function in acute leukemia patients who received peripheral blood stem cell transplantation from HLA matched siblings. Former studies suggest that Regulatory T cells (Tregs) can enhance recovery of a broad T-cell repertoire [6] to promote immune reconstitution and prevent graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation [7]. The protective function in GVHD may because of the KIR-ligand mismatch [9]
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