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Selective T‐cell depletion targeting CD 45 RA reduces viremia and enhances early T‐cell recovery compared with CD 3‐targeted T‐cell depletion
Author(s) -
Triplett Brandon M.,
Muller Brad,
Kang Guolian,
Li Ying,
Cross Shane J.,
Moen Joseph,
Cunningham Lea,
Janssen William,
Mamcarz Ewelina,
Shook David R.,
Srinivasan Ashok,
Choi John,
Hayden Randall T.,
Leung Wing
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12823
Subject(s) - viremia , medicine , immunology , t cell , transplantation , cell , immune system , antibody , biology , genetics
Background T‐cell depletion ( TCD ) effectively reduces severe graft‐versus‐host disease in recipients of HLA ‐mismatched allografts. However, TCD is associated with delayed immune recovery and increased infections. We hypothesized that specific depletion of CD 45 RA + naive T cells, rather than broad depletion of CD 3+ T cells, can preserve memory‐immunity in the allografts and confer protection against important viral infections in the early post‐transplant period. Methods Sixty‐seven patients who received TCD haploidentical donor transplantation for hematologic malignancy on 3 consecutive trials were analyzed. Results Patients receiving CD 45 RA ‐depleted donor grafts had 2000‐fold more donor T cells infused, significantly higher T‐cell counts at Day +30 post transplant (550/μL vs 10/μL; P < .001), and higher T‐cell diversity by Vbeta spectratyping at Day +100 ( P < .001). Importantly, these recipients experienced a significant reduction in both the incidence ( P = .002) and duration ( P = .02) of any viremia (cytomegalovirus, Epstein‐Barr virus, or adenovirus) in the first 6 months post transplant. Specifically, recipients of CD 3‐depleted grafts were more likely to experience adenovirus viremia (27% vs 4%, P = .02). Conclusion CD 45 RA ‐depletion provided a large number of donor memory T cells to the recipients and was associated with enhanced early T‐cell recovery and protection against viremia.