T Regulatory Cells in Donor Grafts May Predict the Severity of Acute Graft Versus Host Disease After Matched Sibling Donor Allogenic Peripheral Blood Stem Cell Transplantation

  • Dinesh Chandra
  • Jasdeep Singh
  • Roopam Deka
  • Ankur Ahuja
  • Rahul Sharma
  • Pravas Mishra
  • Tulika Seth
  • Manoranjan Mahapatra
  • Lalit Kumar
  • Seema Tyagi
  • Renu Saxena
  • Hara Prasad PatiEmail author
Original Article


Acute graft-versus-host disease (aGVHD) and relapse are major issues for patients undergoing allogenic hematopoietic stem cell transplant (allo-HSCT). T-regulatory (Treg) cells in the donor graft are negatively correlated with the incidence of aGVHD without any impact on relapse. In this study to determine the association of Treg cells with aGVHD in allo-HSCT patients. Thirty-two patients with hematological disorders, who underwent allo-HSCT. Twenty-nine patients who achieved engraftment were enrolled in the study. Treg cells were quantified in donor graft by flowcytometry and were assessed for their association with aGVHD and other clinical outcomes. Fifteen of 29 patients developed aGVHD. According to the occurrence and severity of aGVHD, patients were divided into two groups: 20 (68.9%) patients with grade 0–I aGVHD and 9 (31.1%) patients with grade II–IV aGVHD. Treg cells/CD4 ratio was significantly higher in the grade 0–I aGVHD group than in grade II–IV aGVHD group, (p = 0.0002). We could not find the association of CD34 dose (p = 0.55) or CD3 dose (p = 0.57) with the severity of aGVHD. Higher Treg cells/CD4 ratio in donor graft was associated with less severe aGVHD. Though more studies are needed, Treg cells/CD4 ratio may be used as a predictive marker for severity of aGVHD in post allo-HSCT.


T-regulatory cells Acute GVHD Allo-HSCT 



The authors would like to thank, Mrs Veena Pandey, MA, Statistician, and Mr Rajesh, Technical staff, Flowcytometry Lab, AIIMS, New Delhi.

Compliance with Ethical Standards

Conflict of interest

Authors have no conflict of interest to declare.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2019

Authors and Affiliations

  • Dinesh Chandra
    • 1
  • Jasdeep Singh
    • 2
  • Roopam Deka
    • 2
  • Ankur Ahuja
    • 2
  • Rahul Sharma
    • 2
  • Pravas Mishra
    • 2
  • Tulika Seth
    • 2
  • Manoranjan Mahapatra
    • 2
  • Lalit Kumar
    • 3
  • Seema Tyagi
    • 2
  • Renu Saxena
    • 2
  • Hara Prasad Pati
    • 2
    Email author
  1. 1.Department of HematologySanjay Gandhi Post Graduate Institute of Medical SciencesLucknowIndia
  2. 2.Department of HematologyAll India Institute of Medical Sciences (AIIMS)New DelhiIndia
  3. 3.Medical Oncology, IRCHAll India Institute of Medical Sciences (AIIMS)New DelhiIndia

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