Immunomonitoring After Hematopoietic Stem Cell Transplantation

Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative option for many hematologic malignancies, in particular acute leukemias and myelodysplastic syndromes. At the center of these reactions are the donor's T and NK cells. Several studies have highlighted the impact of T cells reconstitution on post-transplant infection rates, relapse and GvHD. Most of the post-allogeneic immune reconstitution studies available to us today include young patients (\<60 years of age) who have had genoidentic or phenoidentic 10/10 allografts and mostly only study the phenotype of a limited number of immune cells. While it is important to know the absolute number reconstitution kinetics of the different categories of immune cells, it is essential to also be able to assess the function of the different cells. Knowledge of the restoration of T function at key dates after allogeneic stem cell transplantation would make it possible to adapt post allogeneic immunomodulation (immunosuppressive treatment and injections of donor lymphocytes) and anti-infectious prophylaxis for patients. The measurement of cytokine profiles after nonspecific stimulation of T and NK lymphocytes recently made available to the immunology laboratory of the CHU de Nice allows a routine assessment of T lymphocyte function (Th1, Th2 Th 17 and T regulatory) and NK by measurement of the secretion of different cytokines after stimulation of the patient's lymphocytes with different antigens (anti-CD3 and anti-TLR7). The cytokine profile during immune reconstitution in hematopoietic cell transplants has never been evaluated; we will analyze it with regard to clinical data: relapse, infections and GVHD.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Patient over 18 years old
* Suffering from a malignant hemopathy
* Allogeneic bone marrow or hematopoietic stem cells
* Identical geno-, pheno- and haplo donors
* Informed consent signed by the patient or the person of trust in case of impossibility (deferred consent of the patient when his condition allows it)
* Affiliated with a social security scheme

Exclusion Criteria:

* Patient with a clinical or biological contraindication to performing an allogeneic transplant
* Patient with progressive solid cancer or in remission for less than 3 years
* HIV-positive patients
* Patients with chronic active hepatitis B or C
* Allogeneic cord blood transplant
* Allograft with sequential conditioning
* Post-allograft preemptive treatment other than injections of donor lymphocytes Withdrawal of informed consent
* Inability to undergo medical monitoring of the study for geographical, social or psychological reasons

Non-inclusion criteria:

* Minor patient
* Pregnant woman
* Patient with congenital or previously acquired immune deficiency
* Patient on prior immunosuppressive treatment
* Patient under guardianship or guardianship or placed in detention