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. 2022 Jul 15:12:916442.
doi: 10.3389/fonc.2022.916442. eCollection 2022.

Immune Reconstitution of Patients Who Recovered From Steroid-Refractory Acute Graft-Versus-Host Disease After Basiliximab Treatment

Dao-Xing Deng  1 , Shuang Fan  1 , Xiao-Hui Zhang  1 , Lan-Ping Xu  1 , Yu Wang  1 , Chen-Hua Yan  1 , Huan Chen  1 , Yu-Hong Chen  1 , Wei Han  1 , Feng-Rong Wang  1 , Jing-Zhi Wang  1 , Xu-Ying Pei  1 , Ying-Jun Chang  1 , Kai-Yan Liu  1 , Xiao-Jun Huang  1   2   3 , Xiao-Dong Mo  1   3
Affiliations

Immune Reconstitution of Patients Who Recovered From Steroid-Refractory Acute Graft-Versus-Host Disease After Basiliximab Treatment

Dao-Xing Deng et al. Front Oncol. .

Abstract

We aimed to identify the characteristics of immune reconstitution (IR) in patients who recovered from steroid-refractory acute graft-versus-host disease (SR-aGVHD) after basiliximab treatment. A total of 179, 124, 80, and 92 patients were included in the analysis for IR at 3, 6, 9, and 12 months, respectively, after haploidentical donor hematopoietic stem cell transplantation (HID HSCT). We observed that IR was fastest for monocytes and CD8+ T cells, followed by lymphocytes, CD3+ T cells, and CD19+ B cells and slowest for CD4+ T cells. Almost all immune cell subsets recovered comparably between patients receiving <5 doses and ≥5 doses of basiliximab. Most immune cell subsets recovered comparably between SR-aGVHD patients who recovered after basiliximab treatment and event-free HID HSCT recipients. Patients who recovered from SR-aGVHD after basiliximab treatment experienced satisfactory IR, which suggested that basiliximab may not have prolonged the negative impact on IR in these patients.

Keywords: Immune reconstitution; acute graft-versus-host disease; allogeneic hematopoietic stem cell transplantation; basiliximab; haploidentical; steroid-refractory.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Diagram of patients enrolled. A total of 327 SR-aGVHD patients who showed an ORR to basiliximab treatment were eligible, and 179, 124, 80, and 92 patients were included in the final analysis for IR at 3, 6, 9, and 12 months, respectively, after HID HSCT. HID HSCT, haploidentical donor hematopoietic stem cell transplantation; IR, immune reconstitution; NRM, non-relapse mortality; ORR, overall response rate; SR-aGVHD, steroid-refractory acute graft-versus-host disease.
Figure 2
Figure 2
(A-L) Kinetics of immune reconstitution in the total population that showed an ORR after basiliximab treatment. Immune cell subsets are compared between basiliximab <5 doses and basiliximab ≥5 doses. Because of lack of data about CD4+CD45RA+ T cells and CD4+CD45RO+ T cells in healthy donors, the values of these two immune cell subsets in healthy donors are not shown. Data are shown as median absolute counts with error bars indicating the 25th–75th percentiles. The horizontal dotted lines represent the median value of healthy cohorts, and the gray areas represent the 25th–75th percentiles for the healthy cohorts. *P < 0.05, basiliximab <5 doses vs. basiliximab ≥5 doses. ORR, overall response rate.
Figure 3
Figure 3
(A-L) Kinetics of immune reconstitution in grade II SR-aGVHD patients who showed an ORR after basiliximab treatment. Because of lack of data about CD4+CD45RA+ T cells and CD4+CD45RO+ T cells in healthy donors, the values of these two immune cell subsets in healthy donors are not shown. Data are shown as median absolute counts with error bars indicating the 25th–75th percentiles. The horizontal dotted lines represent the median value of healthy cohorts, and the gray areas represent the 25th–75th percentiles for the healthy cohorts. *P < 0.05, basiliximab <5 doses vs. basiliximab ≥5 doses. ORR, overall response rate; SR-aGVHD, steroid-refractory acute graft-versus-host disease.
Figure 4
Figure 4
(A-L) Kinetics of immune reconstitution in grade III–IV SR-aGVHD patients who showed an ORR after basiliximab treatment. Because of lack of data about CD4+CD45RA+ T cells and CD4+CD45RO+ T cells in healthy donors, the values of these two immune cell subsets in healthy donors are not shown. Data are shown as median absolute counts with error bars indicating the 25th–75th percentiles. The horizontal dotted lines represent the median value of healthy cohorts, and the gray areas represent the 25th–75th percentiles for the healthy cohorts. *P < 0.05, basiliximab <5 doses vs. basiliximab ≥5 doses. ORR, overall response rate; SR-aGVHD, steroid-refractory acute graft-versus-host disease.
Figure 5
Figure 5
(A–C) Kinetics of IgA, IgG, and IgM in the total population who showed an ORR after basiliximab treatment; (D–F) Kinetics of IgA, IgG, and IgM in grade II SR-aGVHD patients who showed an ORR after basiliximab treatment; (G–I) Kinetics of IgA, IgG, and IgM in grade III–IV SR-aGVHD patients who showed an ORR after basiliximab treatment. IgA, IgG, and IgM are compared between basiliximab <5 doses and basiliximab ≥5 doses. Data are shown as median absolute counts with error bars indicating the 25th–75th percentiles. The gray areas represent the normal range. *P < 0.05, basiliximab <5 doses vs. basiliximab ≥5 doses. ORR, overall response rate; SR-aGVHD, steroid-refractory acute graft-versus-host disease.
Figure 6
Figure 6
(A-J) Immune reconstitution between SR-aGVHD patients who showed an ORR after basiliximab treatment and event-free HID HSCT recipients. Data are shown as median absolute counts with error bars indicating the 25th–75th percentiles. The horizontal dotted lines represent the median value of healthy cohorts, and the gray areas represent the 25th–75th percentiles for the healthy cohorts. *P < 0.05, **P < 0.01, basiliximab any dose vs. event-free HID HSCT. HID HSCT, haploidentical donor hematopoietic stem cell transplantation; ORR, overall response rate; SR-aGVHD, steroid-refractory acute graft-versus-host disease.
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