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Impact of T-cell depletion on outcome of patients undergoing allogeneic hematopoietic cell transplantation for myelodysplastic syndrome

Bone Marrow Transplantation volume 53, pages 1072–1075 (2018)Cite this article

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Myelodysplastic syndromes (MDS) are clonal stem cell disorders usually characterized by cytopenia and dysplasia. MDS are usually diagnosed during the sixth decade and are associated with reduced life expectancy, mainly related to transformation to acute leukemia, infections, or bleeding. Currently, the only potentially curative treatment for MDS is allogeneic hematopoietic stem cell transplantation (HSCT) [1,2,3]. However, HSCT is associated with significant morbidity and mortality mainly related to acute or chronic graft-vs.-host disease (aGvHD or cGvHD) [4, 5]. In the Geneva Stem Cell Transplant Center we use partial in vitro T-cell-depleted grafts usually for patients in complete remission at transplant to reduce GvHD incidence [6]. Indeed, partial T-cell depletion decreases the number of alloreactive donor T cells triggering GvHD. However, it is hypothesized that this strategy could increase relapse incidence (RI) and decrease overall survival (OS) due to the loss of the graft-vs.-leukemia effect mediated by donor lymphocytes. Impact of partial T-cell depletion was previously investigated in a cohort of patients, including heterogeneous diseases and results had shown no worsening of outcome for partially T-cell-depleted patients [7]. However, the impact of partial T-cell depletion was never specifically investigated for patients undergoing transplantation for MDS.

In this retrospective study, we investigated patients allografted for a diagnosis of MDS over a 19 years’ period (from 01 January 1998 to 31 August 2016). Patients aged ≥18 years old at transplant time, who had a diagnosis of MDS according to the 2008 World Health Organization criteria, and who had a first HSCT were included. Patients with haploidentical transplantation, stem cell from identical twins, umbilical cord blood transplantation, or more than two human leukocyte antigen (HLA) loci- or allele-mismatched unrelated donor (MMUD) transplantation were excluded. This study was approved by an ethics committee.

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  1. These authors contributed equally: Maude Raboud, Yan Beauverd.

Authors and Affiliations

  1. Faculty of Biology and Medicine, University of Lausanne, 21 Rue du Bugnon, 1011, Lausanne, Switzerland

    Maude Raboud

  2. Stem Cell and Bone Marrow Transplant Center, Division of Hematology, Geneva’s University Hospitals and University of Geneva Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland

    Yan Beauverd, Federico Simonetta, Carole Dantin, Amandine Pradier, Olga Tsopra, Aikaterini Koutsi, Anne-Claire Mamez, Caroline Stephan, Juan Felipe Rodriguez Morales, Karolina Polchlopek-Blasiak, Yordanka Tirefort, Stavroula Masouridi-Levrat & Yves Chalandon

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  1. Maude Raboud
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Correspondence to Yves Chalandon.

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Raboud, M., Beauverd, Y., Simonetta, F. et al. Impact of T-cell depletion on outcome of patients undergoing allogeneic hematopoietic cell transplantation for myelodysplastic syndrome. Bone Marrow Transplant 53, 1072–1075 (2018). https://doi.org/10.1038/s41409-018-0136-2

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