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Ex vivo T-lymphopoiesis assays assisting corrective treatment choice for genetically undefined T-lymphocytopenia

ZM. Golwala, H. Spiridou Goncalves, RD. Moirangthem, G. Evans, S. Lizot, C. de Koning, A. Garrigue, MM. Corredera, JM. Ocampo-Godinez, E. Howley, S. Kricke, A. Awuah, I. Obiri-Yeboa, R. Rai, N. Sebire, F. Bernard, V. Bordon Cueto De Braem, K....

. 2025 ; 274 (-) : 110453. [pub] 20250216

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc25009294

Persistent selective T-lymphocytopenia is found both in SCID and congenital athymia. Without molecular diagnosis, it is challenging to determine whether HCT or thymus transplantation ought to be performed. Ex vivo T-lymphopoiesis assays have been proposed to assist clinical decision-making for genetically undefined patients. We investigated 20 T-lymphocytopenic patients, including 13 patients awaiting first-line treatment and 7 patients with failed immune reconstitution after previous HCT or thymus transplantation. Whilst developmental blocks in ex vivo T-lymphopoiesis indicated hematopoietic cell-intrinsic defects, successful T-lymphocyte differentiation required careful interpretation, in conjunction with clinical status, immunophenotyping, and genetic investigations. Of the 20 patients, 13 proceeded to treatment, with successful immune reconstitution observed in 4 of the 6 patients post-HCT and 4 of the 7 patients after thymus transplantation, the latter including two patients who had previously undergone HCT. Whilst further validation and standardization are required, we conclude that assessing ex vivo T-lymphopoiesis during the diagnostic pathway for genetically undefined T-lymphocytopenia improves patient outcomes by facilitating corrective treatment choice.

Allergy and Immunology Department The Royal Children's Hospital Melbourne Melbourne Australia

Allergy and Immunology Unit Schneider Children's Medical Center of Israel Kipper Institute of Immunology Petach Tikva Israel

CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences Vienna Austria

Center for Translational Immunology University Medical Center Utrecht

Department of Histopathology Great Ormond Street Hospital for Children NHS Foundation Trust

Department of Immunology 2nd Faculty of Medicine Charles University and University Hospital in Motol Prague Czechia

Department of Immunology and Gene Therapy Great Ormond Street Hospital for Children NHS Foundation Trust

Department of Paediatrics and Adolescent Medicine Infections and Immunology Aarhus University Hospital Aarhus Denmark

Department of Pediatric Hemato Oncology and Hematopoietic Stem cell Transplantation Ghent University Hospital Ghent Belgium

Department of Pediatric Immunology and Infectious Diseases Wilhelmina Children's Hospital University Medical Centre Utrecht

Department of Pediatrics Obstetrics and Gynecology Preventive Medicine and Public Health Faculty of Medicine Universitat Autònoma de Barcelona Barcelona Spain

Division of Immunology and the Children's Research Centre University Children's Hospital Zurich Zurich Switzerland

Geneva Switzerland

Human Lymphohematopoiesis Laboratory Imagine Institute INSERM UMR 1163 Université Paris Cité

Infection Immunity and Inflammation Research and Teaching Department Great Ormond Street Institute of Child Health University College London

Infection in Immunocompromised Pediatric Patients Vall d'Hebron Research Institute Vall d'Hebron Barcelona Hospital Campus Barcelona Spain

London United Kingdom

Medical University of Vienna Department of Pediatrics and Adolescent Medicine Vienna Austria

Paediatric Immunology and Haematopoietic Stem Cell Transplantation Great North Children's Hospital Newcastle upon Tyne United Kingdom

Paediatric Immunology Department University Hospitals of Birmingham Birmingham United Kingdom

Paediatric Onco Haematology Unit Geneva University Hospital

Paris France

Pediatric Hematology Oncology and Stem Cell Transplant Division Padua University Hospital Padua Italy

Pediatric Immunology University of Zurich Zurich Switzerland

Pediatric Infectious Diseases and Immunodeficiencies Unit Department of Pediatrics Hospital Infantil Vall d'Hebron Vall d'Hebron Barcelona Hospital Campus Barcelona Spain

Princess Maxima Center for Pediatric Oncology Utrecht Netherlands

Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

SIHMDS Haematology Great Ormond Street Hospital for Children NHS Foundation Trust

Smart Immune

St Anna Children's Cancer Research Institute Vienna Austria

St Anna Children's Hospital Medical University of Vienna Department of Pediatrics and Adolescent Medicine Vienna Austria

Translational and Clinical Research Institute Newcastle University Newcastle upon Tyne United Kingdom

Utrecht Netherlands

Citace poskytuje Crossref.org

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$a Persistent selective T-lymphocytopenia is found both in SCID and congenital athymia. Without molecular diagnosis, it is challenging to determine whether HCT or thymus transplantation ought to be performed. Ex vivo T-lymphopoiesis assays have been proposed to assist clinical decision-making for genetically undefined patients. We investigated 20 T-lymphocytopenic patients, including 13 patients awaiting first-line treatment and 7 patients with failed immune reconstitution after previous HCT or thymus transplantation. Whilst developmental blocks in ex vivo T-lymphopoiesis indicated hematopoietic cell-intrinsic defects, successful T-lymphocyte differentiation required careful interpretation, in conjunction with clinical status, immunophenotyping, and genetic investigations. Of the 20 patients, 13 proceeded to treatment, with successful immune reconstitution observed in 4 of the 6 patients post-HCT and 4 of the 7 patients after thymus transplantation, the latter including two patients who had previously undergone HCT. Whilst further validation and standardization are required, we conclude that assessing ex vivo T-lymphopoiesis during the diagnostic pathway for genetically undefined T-lymphocytopenia improves patient outcomes by facilitating corrective treatment choice.
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