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Impact of MAIT-cell recovery on outcomes in pediatric and young adult patients undergoing allo-HSCT
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MAIT cells are innate-like T-cells associated with several immunological diseases.1 Several studies have examined the role of MAIT cells in immune reconstitution after allo-HSCT; however, the impact of MAIT cells on GvHD and infections post-transplantation has not yet been fully elucidated.1 A retrospective analysis assessed the impact of reconstitution kinetics and function of MAIT cells on outcomes in 145 pediatric and young adult patients undergoing allo-HSCT with a MUD (n = 52) or haplo-donor (n = 93). Results from this analysis were published in Haematologica by Galaverna et al. In 2024.1 |
| Key learnings |
| Within the first 2 years post-transplant, MAIT cells displayed delayed recovery, prolonged functional impairment, and an increased activation/exhaustion profile, resulting in a suboptimal response to TCR stimulation. |
| A higher absolute number of MAIT cells at Day 30 post-transplant was associated with a higher incidence of Grade II–IV aGvHD (19% vs 7%; p = 0.06) and all grade cGvHD (17% vs 6%; p = 0.06), indicating the potential predictive role of MAIT cells in transplant complications. |
| At Day 30 post-transplant, a higher MAIT-cell count was associated with increased CMV reactivation (44% vs 24%; p = 0.02) and a lower incidence of late BSI (9% vs 19%; p = 0.08). |
| Early MAIT-cell recovery monitoring may be helpful in predicting complications, including GvHD and infection risks, which may potentially guide post-transplant therapeutic strategies. |
Abbreviations: aGvHD, acute graft-versus-host disease; allo-HSCT, allogeneic hematopoietic stem cell transplantation; BSI, bloodstream infection; cGvHD, chronic graft-versus-host disease; CMV, cytomegalovirus; GvHD, graft-versus-host disease; haplo, haploidentical; MAIT, mucosal-associated invariant T, MUD, matched unrelated donor; TCR, T-cell receptor.
- Galaverna F, Flamini S, De Luca CD, et al. Mucosal-associated invariant T cells are functionally impaired in pediatric and young adult patients following allogeneic hematopoietic stem cell transplantation and their recovery correlates with clinical outcomes. Haematologica. 2024;109(10):3222–3236. DOI: 3324/haematol.2023.284649
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