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@ARTICLE{Leserer:275345,
author = {S. Leserer and T. Graf and M. Franke and R. Bogdanov and E.
Arrieta-Bolaños$^*$ and U. Buttkereit and N. Leimkühler
and K. Fleischhauer$^*$ and H. C. Reinhardt and D. W. Beelen
and A. T. Turki},
title = {{T}ime series clustering of {T} cell subsets dissects
heterogeneity in immune reconstitution and clinical outcomes
among {MUD}-{HCT} patients receiving {ATG} or {PTC}y.},
journal = {Frontiers in immunology},
volume = {14},
issn = {1664-3224},
address = {Lausanne},
publisher = {Frontiers Media},
reportid = {DKFZ-2023-00714},
pages = {1082727},
year = {2023},
abstract = {Anti-T-lymphocyte globulin (ATG) or post-transplant
cyclophosphamide (PTCy) prevent graft-versus-host disease
(GVHD) after hematopoietic cell transplantation (HCT), yet
individual patients benefit differentially.Given the sparse
comparative data on the impact of cellular immune
reconstitution in this setting, we studied flow cytometry
and clinical outcomes in 339 recipients of 10/10
matched-unrelated donor (MUD) HCT using either ATG (n=304)
or PTCy (n=35) for in vivo T cell manipulation along with a
haploidentical PTCy control cohort (n=45). Longitudinal
cellular immune reconstitution data were analyzed
conventionally and with a data science approach using
clustering with dynamic time warping to determine the
similarity between time-series of T cell subsets.Consistent
with published studies, no significant differences in
clinical outcomes were observed at the cohort level between
MUD-ATG and MUD-PTCy. However, cellular reconstitution
revealed preferences for distinct T cell subpopulations
associating with GVHD protection in each setting. Starting
early after HCT, MUD-PTCy patients had higher regulatory T
cell levels after HCT (p <0.0001), while MUD-ATG patients
presented with higher levels of γδ T- or NKT cells (both p
<0.0001). Time-series clustering further dissected the
patient population's heterogeneity revealing distinct immune
reconstitution clusters. Importantly, it identified
phenotypes that reproducibly associated with impaired
clinical outcomes within the same in vivo T cell
manipulation platform. Exemplarily, patients with lower
activated- and αβ T cell counts had significantly higher
NRM (p=0.032) and relapse rates (p =0.01).The improved
understanding of the heterogeneity of cellular
reconstitution in MUD patients with T cell manipulation both
at the cohort and individual level may support clinicians in
managing HCT complications.},
keywords = {Humans / Time Factors / Immune Reconstitution /
Antilymphocyte Serum / Hematopoietic Stem Cell
Transplantation: adverse effects / Cyclophosphamide / Graft
vs Host Disease / T-Lymphocyte Subsets / GVHD prophylaxis
(Other) / anti-T-lymphocyte globulin (Other) /
anti-thymocyte globulin (ATG) (Other) / dynamic time warping
(DTW) (Other) / matched unrelated donor allogeneic
hematopoietic stem cell transplantation (Other) /
post-transplant cyclophosphamide (Other) / time-series (TS)
model (Other) / unsupervised learning (Other) /
Antilymphocyte Serum (NLM Chemicals) / Cyclophosphamide (NLM
Chemicals)},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37020562},
pmc = {pmc:PMC10067907},
doi = {10.3389/fimmu.2023.1082727},
url = {https://inrepo02.dkfz.de/record/275345},
}