Among patients with acute myeloid leukemia (AML) who undergo haploidentical allogeneic hematopoietic cell transplantation (haplo-HCT), greater Vδ2-positive T-cell recovery is linked with both improved nonrelapse mortality (NRM) and overall survival (OS), according to research published in the Annals of Hematology.
Patients with AML who undergo chemotherapy have a poor prognosis, although haplo-HCT has helped to increase OS and potentially long-term remission in this population. There is, however, a period after transplantation where patients are immunocompromised and may develop graft vs host disease (GVHD); there is also an increased risk of infection during this period.
Previous research has shown that T-lymphocyte recovery is critical for improving NRM and OS in this patient population, though study of T lymphocyte subsets is wanting. For this study, researchers evaluated whether Vδ2-positive T-cell recovery is linked with improved clinical outcomes and reduced GVHD rates among patients with AML undergoing haplo-HCT.
Overall, data from 103 patients with AML were included. Among these, the median age was 33 years (range, 1-59 years), 55% of patients were male sex, and 83% of patients had negative minimal residual disease at HCT.
Analysis showed that, on day 90, the absolute number of Vδ2-positive T-cells predicted 2-year OS (hazard ratio, 3.56; P =.027). This was, furthermore, apparently related to a reduction in NRM, specifically infection-related mortality. However, higher day 90 Vδ2-positive T-cells did not predict for lower rates of acute GVHD or bacteremia.
Higher levels of Vδ2-positive T cells on day 270 did, however, predict lower probabilities of 2-year and 5-year relapse (both P <.05).
“Establishment of Vδ2-[positive] T cells-based treatment strategies may facilitate to achieve long-term superior outcomes of AML patients,” the authors wrote in their report.
Yue K, Gao H, Liang S, et al. Improved Vδ2+ T cells recovery correlates to reduced incidences of mortality and relapse in acute myeloid leukemia after hematopoietic transplantation. Ann Hematol. Published online February 10, 2023. doi:10.1007/s00277-023-05125-5