Abstract

Alterations in immune reconstitution have been implicated with the development of chronic graft-versus-host disease (cGVHD) in allogeneic bone marrow transplantation (BMT) recipients. Since T cells are important mediators in this disease, the aim of this study was to search for a biologic marker for cGVHD moderate and severe forms. T cell subpopulations were studied in cGVHD patients according to the proposal of the NIH consensus criteria at diagnosis, thus, in the absence of immune suppression. We present a one year follow up in a cohort of 42 BMT patients in a prospective analysis of peripheral blood and tissue biopsies collected for diagnostic purposes. Clinical characteristics of patients with (n = 19) or without (n = 23) cGVHD were not statistically different, as well as reconstitution kinetics in peripheral blood of CD4+, CD8+ and regulatory T cells in both groups. However, immunohistochemistry from four different organs/tissues analyzed at cGVHD onset showed similar characteristics. There was a predominance of CD8 T cell infiltration in close contact with lesion areas, with poor and distant CD4 T cell infiltration and a paucity or absence of Tregs. Our data suggest the pattern of T cell infiltration as a diagnostic marker for cGVHD.

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