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T-cell frequencies of CD8+ γδ and CD27+ γδ cells in the stem cell graft predict the outcome after allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation (2019) | Download Citation


The impact of intra-graft T cells on the clinical outcome after allogeneic hematopoietic cell transplantation has been investigated. Most previous studies have focused on the role of αβ cells while γδ cells have received less attention. It has been an open question whether γδ cells are beneficial or not for patient outcome, especially with regards to graft versus host disease. In this study, graft composition of γδ cell subsets was analyzed and correlated to clinical outcome in 105 recipients who underwent allogeneic hematopoietic cell transplantation between 2013 and 2016. We demonstrate for the first time that grafts containing higher T-cell proportions of CD8+γδ cells were associated with increased cumulative incidence of acute graft versus host disease grade II–III (50% vs 22.6%; P = 0.008). Additionally, graft T-cell frequency of CD27+γδ cells was inversely correlated with relapse (P = 0.006) and CMV reactivation (P = 0.05). We conclude that clinical outcome after allogeneic hematopoietic cell transplantation is influenced by the proportions of distinct γδ cell subsets in the stem cell graft. We also provide evidence that CD8+γδ cells are potentially alloreactive and may play a role in acute graft versus host disease. This study illustrates the importance of better understanding of the role of distinct subsets of γδ cells in allogeneic hematopoietic cell transplantation.

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This study was supported by Stockholm county Council, Swedish research Council, Children Cancer Foundation, and Radiumhemmets Forskningsfonder.

Author contributions

MU supervised the study. AG and AS performed laboratory work and data analysis. EW, MS, and JM provided graft samples and clinical data. BÖ and MU interpreted the data. AG and MU wrote the manuscript. All coauthors critically revised the manuscript.

Author information


  1. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

    • Ahmed Gaballa
    • , Mikael Sundin
    • , Emma Watz
    •  & Michael Uhlin
  2. Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden

    • Arwen Stikvoort
    •  & Jonas Mattsson
  3. Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

    • Björn Önfelt
  4. Department of Applied Physics, Science for Life Laboratory, Royal Institute of Technology, Stockholm, Sweden

    • Björn Önfelt
    •  & Michael Uhlin
  5. Section of Paediatric Hematology, Immunology and Hematopoietic Cell Transplantation, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden

    • Mikael Sundin
  6. Department of Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden

    • Emma Watz
    •  & Michael Uhlin


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The authors declare that they have no conflict of interest.

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Correspondence to Ahmed Gaballa or Michael Uhlin.

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