Gamma delta T cell reconstitution in Acute Lymphoblastic Leukemia patients post allogeneic HSCT predicts clinical outcome and overall survival.
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Predicting the transplant outcome of Acute Lymphoblastic Leukemia patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a challenge. It is necessary to have prognostic biomarkers that can be monitored in these patients. In the present single center, long term follow-up study, immune cell composition or the immunophenotype of Acute Lymphoblastic Leukemia patients (n = 14) was analyzed at various intervals following allogeneic HSCT and correlated with clinical outcomes. Long-term survivors post-HSCT showed distinct immune cell profiles compared to non-survivors. Long term survivors exhibited higher expression of Vδ2+CD69+ (p = 0.0126), and Vδ1+CD16b+ T cells (p = 0.0485) at baseline, compared to non-survivors. The analysis of donor immune cell composition showed difference at baseline, donors with higher levels of NKT+ cells and lower Vδ1+perforin+ T cells led to longer survival of respective recipients. Earlier WBC engraftment and incidence of chronic GVHD were other independent clinical factors associated with higher overall survival post- allogeneic HSCT. Furthermore, donors with higher baseline percentages of γδ T cells, CD19+ B cells, CD4 T cells, Vδ2 Naïve, Vδ2 TemRA, CD3+CD25+, and Vδ2+CD25+; and low Effector Memory CD3+ and Vδ1+ T cells were associated with fewer Cytomegalovirus (CMV) reactivation in their recipients. The present study underscores the importance of compositional analysis of immune cells in both recipients and donors as a discerning predictive tool for anticipating long-term clinical outcomes following allogeneic HSCT and highlights the need for future validation in larger cohorts.