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Legrand N, Salameh P, Jullien M, Chevallier P, Ferron E, David G, Devilder MC, Willem C, Gendzekhadze K, Parham P, Retière C, Gagne K. Non-Expressed Donor KIR3DL1 Alleles May Represent a Risk Factor for Relapse after T-Replete Haploidentical Hematopoietic Stem Cell Transplantation. Cancers (Basel) 2023; 15:2754. [PMID: 37345091 DOI: 10.3390/cancers15102754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
KIR3DL1 alleles are expressed at different levels on the natural killer (NK) cell surface. In particular, the non-expressed KIR3DL1*004 allele appears to be common in Caucasian populations. However, the overall distribution of non-expressed KIR3DL1 alleles and their clinical relevance after T-replete haploidentical hematopoietic stem cell transplantation (hHSCT) with post-transplant cyclophosphamide remain poorly documented in European populations. In a cohort of French blood donors (N = 278), we compared the distribution of expressed and non-expressed KIR3DL1 alleles using next-generation sequencing (NGS) technology combined with multi-color flow cytometry. We confirmed the predominance of the non-expressed KIR3DL1*004 allele. Using allele-specific constructs, the phenotype and function of the uncommon KIR3DL1*019 allotype were characterized using the Jurkat T cell line and NKL transfectants. Although poorly expressed on the NK cell surface, KIR3DL1*019 is retained within NK cells, where it induces missing self-recognition of the Bw4 epitope. Transposing our in vitro observations to a cohort of hHSCT patients (N = 186) led us to observe that non-expressed KIR3DL1 HSC grafts increased the incidence of relapse in patients with myeloid diseases. Non-expressed KIR3DL1 alleles could, therefore, influence the outcome of hHSCT.
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Affiliation(s)
- Nolwenn Legrand
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
| | - Perla Salameh
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
| | - Maxime Jullien
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
- Department of Hematology Clinic, Nantes University Hospital, F-44000 Nantes, France
| | - Patrice Chevallier
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
- Department of Hematology Clinic, Nantes University Hospital, F-44000 Nantes, France
| | - Enora Ferron
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
| | - Gaelle David
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
| | - Marie-Claire Devilder
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
| | - Catherine Willem
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
| | - Ketevan Gendzekhadze
- Department of Hematology and HCT, HLA Laboratory, City of Hope, Medical Center, Duarte, CA 91010, USA
| | - Peter Parham
- Department of Structural Biology and Microbiology & Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Christelle Retière
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
| | - Katia Gagne
- Etablissement Français du Sang (EFS), F-44011 Nantes, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1307, CNRS UMR 6075, Centre de Recherche en Cancérologie et Immunologie Integrée Nantes Angers (CRCI2NA), Team 12, F-44000 Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", F-44000 Nantes, France
- LabEx Transplantex, Université de Strasbourg, F-67000 Strasbourg, France
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Jullien M, Orvain C, Berceanu A, Couturier MA, Guillaume T, Peterlin P, Garnier A, Le Bourgeois A, Klemencie M, Schmidt A, Hunault M, Daguindau E, Roussel X, Delepine P, Guillerm G, Giltat A, François S, Thepot S, Le Gouill S, Béné MC, Chevallier P. Impact of allogeneic stem cell transplantation comorbidity indexes after haplotransplant using post-transplant cyclophosphamide. Cancer Med 2021; 10:7194-7202. [PMID: 34547182 PMCID: PMC8525117 DOI: 10.1002/cam4.4262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/11/2021] [Accepted: 08/26/2021] [Indexed: 01/11/2023] Open
Abstract
Background Three different scoring systems have been developed to assess pre‐transplant comorbidity in allogeneic hematopoietic stem cell transplantation (Allo‐HSCT): the Hematopoietic Cell Transplantation‐Specific Comorbidity Index, the Comorbidity/Age index, and the Augmented Comorbidity/Age index. All were devised to predict overall survival (OS) and disease‐free survival (DFS) survivals and non‐relapse mortality (NRM) in patients receiving HLA‐matched Allo‐HSCT, but their performance has scarcely been studied in the haploidentical Allo‐HSCT setting with post‐transplant cyclophosphamide, a procedure in constant expansion worldwide. Methods To address this issue, their impact on survivals and NRM was examined in a cohort of 223 patients treated with haploidentical Allo‐HSCT in four different centers. Results With a median follow‐up of 35.6 months, 3‐year OS, DFS, and NRM were 48.1% ± 4%, 46.3% ± 4%, and 30.0% ± 3%, respectively. No impact was found for any of the three comorbidity scores in univariate analysis. In multivariate analyses, the only three factors associated with lower OS were DRI (p < 0.001), an older age of recipients (≥55 years old, p = 0.02) and of donors (≥40 years old, p = 0.005). Older donor age was also associated with lower DFS and higher NRM. Conclusion The comorbidity scores do not predict survivals nor NRM in haploidentical Allo‐HSCT with PTCY, suggesting that pre‐transplant comorbidities should not be a contra‐indication to this procedure.
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Affiliation(s)
- Maxime Jullien
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Corentin Orvain
- Hematology Department, Angers University Hospital, Angers, France
| | - Ana Berceanu
- Hematology Department, Besançon University Hospital, Besançon, France
| | | | | | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Alice Garnier
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Marion Klemencie
- Hematology Department, Angers University Hospital, Angers, France
| | - Aline Schmidt
- Hematology Department, Angers University Hospital, Angers, France
| | - Mathilde Hunault
- Hematology Department, Angers University Hospital, Angers, France
| | - Etienne Daguindau
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Xavier Roussel
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Pascal Delepine
- Cell therapy Unit, Etablissement Français du Sang - Bretagne, Site of Brest, Brest, France
| | - Gaelle Guillerm
- Hematology Department, Brest University Hospital, Brest, France
| | - Aurelien Giltat
- Hematology Department, Angers University Hospital, Angers, France
| | - Sylvie François
- Hematology Department, Angers University Hospital, Angers, France
| | - Sylvain Thepot
- Hematology Department, Angers University Hospital, Angers, France
| | - Steven Le Gouill
- Hematology Department, Nantes University Hospital, Nantes, France.,INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France
| | - Marie-C Béné
- INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France.,Hematology Biology, Nantes University Hospital, Nantes, France
| | - Patrice Chevallier
- Hematology Department, Nantes University Hospital, Nantes, France.,INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France
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Jullien M, Orvain C, Berceanu A, Couturier MA, Guillaume T, Peterlin P, Garnier A, Bourgeois AL, Klemencie M, Schmidt A, Hunault M, Daguindau E, Roussel X, Delepine P, Guillerm G, Giltat A, François S, Thepot S, Gouill SL, Béné MC, Chevallier P. Early Post-Transplantation Serum Ferritin Level Predicts Survival in Recipients of Haploidentical Stem Cell Transplantation Using Post-Transplantation Cyclophosphamide as Graft-versus-Host Disease Prophylaxis. Transplant Cell Ther 2021; 27:861.e1-861.e7. [PMID: 34245928 DOI: 10.1016/j.jtct.2021.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022]
Abstract
The negative impact of high serum ferritin level (SFL) before and after allogeneic hematopoietic cell transplantation (allo-HSCT) on outcomes is well recognized. However, it is poorly documented in adults undergoing haploidentical HSCT (haplo-HSCT) with post-transplantation cyclophosphamide (PTCY) for hematologic malignancies. The main objective was to assess the impact of pretransplantation and post-transplantation SFL on overall survival (OS), disease-free survival (DFS), and nonrelapse mortality (NRM) in patients undergoing haplo-HSCT with PTCY. The secondary objective was to identify factors associated with outcomes after transplantation by comparing SFL with other parameters related to the status of patients or donors. This multicentric retrospective study included 223 consecutive patients who underwent haplo-HSCT with PTCY in 4 French centers (Nantes, Angers, Besançon, and Brest) between October 2013 and January 2020. The impact of SFL on OS, DFS, and NRM at different time points was assessed based on receiver operating characteristic curves. With a median follow-up of 37.6 months (interquartile range, 23.5 to 51.0 months), 3-year OS, DFS, and NRM were 48.1 ± 4%, 46.3 ± 4%, and 30.0 ± 3%, respectively. Pretransplantation SFL had no impact on outcomes irrespective of the cutoff tested. Considering patients alive at 3 months post-transplantation, an SFL ≥3500 µg/L at 3 months was statistically significantly associated with worse 3-year OS (32.7 ± 8.7% versus 53.4 ± 7.2%; P = .01) and DFS (30.1 ± 8.2% versus 53.1 ± 7.1%; P = .008), with a trend toward higher NRM (33.2 ± 8.6% versus 17.6 ± 5.4%; P = .10). Similarly, high SFL (≥2700 µg/L) at 6 months post-transplantation was associated with worse 3-year OS (56.1 ± 9.1% versus 79.2 ± 6.0%; P = .02) and DFS (53.6 ± 8.7% versus 74.9 ± 6.2%; P = .01), with a trend toward higher NRM (21.4 ± 7.4% versus 8.2 ± 4.0%; P = .10). In multivariate analysis, high 3-month and 6-month FL remained associated with lower OS and DFS, with a trend toward higher NRM. Pretransplantation SFL appears to have no impact on outcomes in haplo-HSCT with PTCY, in contrast to what is documented in the matched allo-HSCT setting. In contrast, in the haplo-HSCT setting, high SFL early post-transplantation is associated with lower survival and a trend toward higher NRM.
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Affiliation(s)
- Maxime Jullien
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Corentin Orvain
- Hematology Department, Angers University Hospital, Angers, France; INSERM, CRCINA, University of Angers, Angers, France
| | - Ana Berceanu
- Hematology Department, Besançon University Hospital, Besançon, France
| | | | | | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Alice Garnier
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Marion Klemencie
- Hematology Department, Angers University Hospital, Angers, France
| | - Aline Schmidt
- Hematology Department, Angers University Hospital, Angers, France; INSERM, CRCINA, University of Angers, Angers, France
| | - Mathilde Hunault
- Hematology Department, Angers University Hospital, Angers, France; INSERM, CRCINA, University of Angers, Angers, France
| | - Etienne Daguindau
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Xavier Roussel
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Pascal Delepine
- Cell Therapy Unit, Etablissement Français du Sang-Bretagne, Brest, France
| | - Gaelle Guillerm
- Hematology Department, Brest University Hospital, Brest, France
| | - Aurelien Giltat
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Sylvie François
- Hematology Department, Angers University Hospital, Angers, France
| | | | - Steven Le Gouill
- Hematology Department, Nantes University Hospital, Nantes, France; INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France
| | - Marie-C Béné
- INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France; Hematology Biology, Nantes University Hospital, Nantes, France
| | - Patrice Chevallier
- Hematology Department, Nantes University Hospital, Nantes, France; INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France.
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Chevallier P, Berceanu A, Peterlin P, Garnier A, Le Bourgeois A, Imbert BM, Daguindau E, Mahé B, Dubruille V, Blin N, Touzeau C, Gastinne T, Lok A, Tessoulin B, Vantyghem S, Desbrosses Y, Bressollette C, Duquesne A, Eveillard M, Le Bris Y, Dormoy A, Malugani C, Deconinck E, Moreau P, Le Gouill S, Béné MC, Guillaume T. Grade 2 acute GVHD is a factor of good prognosis in patients receiving peripheral blood stem cells haplo-transplant with post-transplant cyclophosphamide. Acta Oncol 2021; 60:466-474. [PMID: 33112687 DOI: 10.1080/0284186x.2020.1837947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The impact of acute graft versus host disease (GVHD) on survivals for patients receiving a haploidentical allogeneic stem-cell transplant (Allo-SCT) with peripheral blood stem-cells (PBSC) complemented by post-transplant cyclophosphamide (PTCY) is ill-known. MATERIAL AND METHODS This retrospective study included 131 patients who received a PBSC haplograft in order to precise the impact of acute GVHD on outcomes. There were 78 males and 53 females and the median age for the whole cohort was 59 years (range: 20-71). Thirty-five patients were allografted for a lymphoid disease and 96 for a myeloid malignancy, including 67 patients with acute myeloid leukemia (AML). RESULTS The cumulative incidence (CI) of day 100 grade 2-4 and 3-4 acute GVHD was 43.4 + 4.6% and 16.7 + 3.4%, respectively. The 2-year CI of moderate/severe chronic GVHD was 10.1 + 2.8%. The only factor affecting the occurrence of GVHD was GVHD prophylaxis. Indeed, CI of day 100 grade 2-4 (but not grade 3-4) acute GVHD was significantly reduced when adding anti-thymoglobulin (ATG) to PTCY. However, in multivariate analysis, grade 2 acute GVHD was significantly associated with better disease-free (HR: 0.36; 95%CI: 0.19-0.69, p = .002) and overall (HR: 0.35; 95%CI: 0.1-0.70, p = .003) survivals. The same results were observed when considering only AML patients. CONCLUSION Acute grade 2 GVHD is a factor of good prognosis after PBSC haplotransplant with PTCY. Further and larger studies are needed to clarify the complex question of GVHD prophylaxis in the setting of haplo-transplant, especially that of combining ATG and PTCY.
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Affiliation(s)
| | | | | | - Alice Garnier
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | | | | | - Béatrice Mahé
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | - Nicolas Blin
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | | | - Anne Lok
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | | | | | | | - Alix Duquesne
- Cellular Engineering Unit, EFS Pays de la Loire, Nantes, France
| | | | - Yannick Le Bris
- Hematology/Biology Department, CHU Hotel-Dieu, Nantes, France
| | - Anne Dormoy
- EFS Bourgogne Franche-Comté, Besançon, France
| | | | - Eric Deconinck
- Hematology Department, CHU, Besançon, France
- Université de Franche-Comté, Inserm UMR1098 RIGHT, Besançon, France
| | | | | | - Marie C. Béné
- Hematology/Biology Department, CHU Hotel-Dieu, Nantes, France
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Centromeric KIR AA Individuals Harbor Particular KIR Alleles Conferring Beneficial NK Cell Features with Implications in Haplo-Identical Hematopoietic Stem Cell Transplantation. Cancers (Basel) 2020; 12:cancers12123595. [PMID: 33271841 PMCID: PMC7760878 DOI: 10.3390/cancers12123595] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/25/2022] Open
Abstract
We have recently shown a broad disparity of Natural Killer (NK) cell responses against leukemia highlighting good and bad responders resting on the Killer cell Immunoglobulin-like Receptors (KIR) and HLA genetics. In this study, we deeply studied KIR2D allele expression, HLA-C recognition and functional effect on NK cells in 108 blood donors in combining high-resolution KIR allele typing and multicolor flow cytometry. The KIR2DL1*003 allotype is associated with centromeric (cen) AA motif and confers the highest NK cell frequency, expression level and strength of KIR/HLA-C interactions compared to the KIR2DL1*002 and KIR2DL1*004 allotypes respectively associated with cenAB and BB motifs. KIR2DL2*001 and *003 allotypes negatively affect the frequency of KIR2DL1+ and KIR2DL3+ NK cells. Altogether, our data suggest that cenAA individuals display more efficient KIR2DL alleles (L1*003 and L3*001) to mount a consistent frequency of KIR2DL+ NK cells and to confer an effective NK cell responsiveness. The transposition of our in vitro observations in the T-replete haplo-identical HSCT context led us to observe that cenAA HSC grafts limit significantly the incidence of relapse in patients with myeloid diseases after T-replete haplo-identical HSCT. As NK cells are crucial in HSCT reconstitution, one could expect that the consideration of KIR2DL1/2/3 allelic polymorphism could help to refine scores used for HSC donor selection.
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Makanga DR, Guillaume T, Willem C, Legrand N, Gagne K, Cesbron A, Gendzekhadze K, Peterlin P, Garnier A, Le Bourgeois A, Béné MC, Chevallier P, Retière C. Posttransplant Cyclophosphamide and Antithymocyte Globulin versus Posttransplant Cyclophosphamide as Graft-versus-Host Disease Prophylaxis for Peripheral Blood Stem Cell Haploidentical Transplants: Comparison of T Cell and NK Effector Reconstitution. THE JOURNAL OF IMMUNOLOGY 2020; 205:1441-1448. [DOI: 10.4049/jimmunol.2000578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/04/2020] [Indexed: 12/16/2022]
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