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Clinical and basic implications of dynamic T cell receptor clonotyping in hematopoietic cell transplantation
Simona Pagliuca, … , Betty K. Hamilton, Jaroslaw P. Maciejewski
Simona Pagliuca, … , Betty K. Hamilton, Jaroslaw P. Maciejewski
Published July 8, 2021
Citation Information: JCI Insight. ;6(13):e149080. https://doi.org/10.1172/jci.insight.149080.
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Research Article Hematology Immunology

Clinical and basic implications of dynamic T cell receptor clonotyping in hematopoietic cell transplantation

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Abstract

TCR repertoire diversification constitutes a foundation for successful immune reconstitution after allogeneic hematopoietic cell transplantation (allo-HCT). Deep TCR Vβ sequencing of 135 serial specimens from a cohort of 35 allo-HCT recipients/donors was performed to dissect posttransplant TCR architecture and dynamics. Paired analysis of clonotypic repertoires showed a minimal overlap with donor expansions. Rarefied and hyperexpanded clonotypic patterns were hallmarks of T cell reconstitution and influenced clinical outcomes. Donor and pretransplant TCR diversity as well as divergence of class I human leukocyte antigen genotypes were major predictors of recipient TCR repertoire recovery. Complementary determining region 3–based specificity spectrum analysis indicated a predominant expansion of pathogen- and tumor-associated clonotypes in the late post–allo-HCT phase, while autoreactive clones were more expanded in the case of graft-versus-host disease occurrence. These findings shed light on post–allo-HCT adaptive immune reconstitution processes and possibly help in tracking alloreactive responses.

Authors

Simona Pagliuca, Carmelo Gurnari, Sanghee Hong, Ran Zhao, Sunisa Kongkiatkamon, Laila Terkawi, Misam Zawit, Yihong Guan, Hassan Awada, Ashwin Kishtagari, Cassandra M. Kerr, Thomas LaFramboise, Bhumika J. Patel, Babal K. Jha, Hetty E. Carraway, Valeria Visconte, Navneet S. Majhail, Betty K. Hamilton, Jaroslaw P. Maciejewski

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Figure 6

Impact of CMV on TCR organization.

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Impact of CMV on TCR organization.
(A) ISI distribution in recipients at...
(A) ISI distribution in recipients at day +100 according to recipient (left) and donor (right) CMV serological status. Recipient negative CMV status (pink box, n = 5); recipient positive CMV (light blue, n = 22); donor negative CMV (pink, n = 17); donor positive CMV (light blue, n = 10). One dot per sample. Recipient status: P = 0.832; donor status: P = 0.011. (B) Number of unique clonotypes in recipients at day +100 according to recipient (left) and donor (right) status. Recipient: P = 0.662; donor: P = 0.028. (C) Number of unique pathologically expanded clonotypes in recipients at day +100 according to recipient (left) and donor (right) status. Recipient: P = 0.512; donor: P = 0.183. (D) Mean size pathological expansion in recipients at day +100 according to recipient (left) and donor (right) CMV serological status. (E) ISI distribution in recipients at day +100 according to D/R CMV status match. D–/R– (n = 3); D–/R+ (n = 14); D+/R– (n = 2); D+R+ (n = 8). Pairwise comparisons with D–/R– category. (D–/R+: P = 0.244; D–/R+: P = 0.210; D+/R+: P = 0.024.) (F) Number of unique clonotypes in recipients at day +100 according to D/R CMV status match. Pairwise comparisons with D–/R– category. (D–/R+: P = 0.164; D+/R–: P = 0.200; D+/R+: P = 0.0091.) (G) Number of unique pathologically expanded clonotypes in recipients at day +100 according to D/R CMV status match. Pairwise comparisons with D–/R– category. (D–/R+: P = 0.147; D+/R–: P = 0.600; D+/R+: P = 0.012.) (H) Mean size pathological expansion in recipients at day +100 according to D/R CMV status match. Pairwise comparisons with D–/R– category. (D–/R+: P = 0.768; D+/R–: P = 0.267; D+/R+: P = 0.084.) (I) Proportion of anti-CMV specificities within the whole repertoire. (J) Number of anti-CMV clonotypes per sample for each sample group. Pairwise comparisons with donor category. (Pre-HCT P = 0.703; day +30 P = 0.00079; day +100 P = 0.00687; day +180 P = 0.00061.) All analyses included in the study of anti-CMV CDR3 sequences were performed on the nondownsampled data set to capture all specificities. All P values were 2 sided. Wilcoxon rank sum. *P < 0.05, **P < 0.01, ***P < 0.001.

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