Skewing of the T-cell receptor repertoire in patients receiving rituximab after allogeneic hematopoietic cell transplantation: what lies beneath?

Abstract:

:Rituximab is known to affect T cell immune responses. We and others have reported expansions of T large granular lymphocytes (T-LGLs) in lymphoma patients after Rituximab. We report here the immunogenetic profiling of the T cell receptor (TR) gene repertoire in 14 patients who received Rituximab post allo-HCT and explore clinicobiological correlations. All experienced antigenic triggers, CMV, EBV re-activation and chronic GvHD and had been treated with Rituximab. Skewing of TRBV genes was observed: 3 TRBV genes accounted for half of the repertoire. Oligoclonal pattern with expanded clonotypes was common. Patients with oligoclonality exhibited frequently cGvHD. Longitudinal samples in one revealed distinct clonotypes, suggesting clonal drift. T-LGL leukemia of donor origin with mixed chimerism eventually developed. In conclusion, we report development of oligoclonal T-LGLs after Rituximab post allo-HCT, alluding to antigen selection. Persistence of this phenomenon likely reflects strong antigenic stimulation by viruses and/or cGVHD aggravated by Rituximab.

journal_name

Leuk Lymphoma

journal_title

Leukemia & lymphoma

authors

Papalexandri A,Karypidou M,Stalika E,Kotta K,Touloumenidou T,Zerva P,Paleta A,Mallouri D,Batsis I,Sakellari I,Kotsianidis I,Anagnostopoulos A,Hadzidimitriou A,Margaritis D,Stamatopoulos K

doi

10.1080/10428194.2018.1543881

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

1685-1692

issue

7

eissn

1042-8194

issn

1029-2403

journal_volume

60

pub_type

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