Unusual expansion of CD3+CD56+ natural killer T-like cells in peripheral blood after anticytokine treatment for graft-versus-host disease: A case report

Medicine
Lixia ShengHe Huang

Abstract

Basiliximab and etanercept have achieved promising responses in steroid-refractory graft versus host disease (SR-GVHD). However, the in vivo immune changes following the treatment have not been elucidated. A 14-year-old boy presented with skin rash and diarrhea 20 days after haploidentical hemotopoietic stem cell transplantation. We made the diagnose of grade 3 acute GVHD with skin and gastrointestinal involvement. After the failure of the first-line treatment with methylprednisolone, combined anti-cytokine therapies with basiliximab and etanercept were prescibed. He achieved complete remission by basiliximab and etanercept. Furthermore, we detected that donor CD3CD56 Natural killer T(NKT)-like cells expanded gradually after the period of lymphocytopenia caused by GVHD and anti-cytokine therapy. The expansion of NKT-like cells was in association with high serum IFN-γ. NKT-like cells showed preferred proliferation in response to IFN-γ and potent cytotoxicity against leukemia cells. The expansion persisted > 2 years and the patient had a leukemia-free survival of 66 months. Our case indicated that combined anti-cytokine treatment may reset the immune system and cause NKT-like cells to exhibit a predilection for expansion.

References

Nov 6, 2003·Toxicology·Maritha Marcusson-Ståhl, Karin Cederbrant
Apr 14, 2004·Current Pharmaceutical Design·David A Jacobsohn, Georgia B Vogelsang
Mar 14, 2009·Lancet·James L M FerraraErnst Holler
Jun 16, 2009·Pediatric Blood & Cancer·Yin LiuCi Pan

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Citations

Jan 8, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Elena Gómez-MassaEstela Paz-Artal
Sep 29, 2020·Recent Patents on Anti-cancer Drug Discovery·Romeo G Mihăilă

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Methods Mentioned

BETA
flow cytometry
PCR
PMA
fluorescence-activated cell sorting

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