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EBMT 2026 | Haploidentical transplantation with TCRαβ-depleted graft and upfront memory T-cell add-back

Liang Piu Koh, MBBS, MRCP, National University Cancer Institute, Singapore, Singapore, discusses the innovative approach of haploidentical transplantation with a TCRαβ-depleted graft and upfront memory T-cell add-back in adults with hematological malignancies, which aims to reduce the risk of graft-versus-host disease (GvHD) while preserving beneficial T-cell subsets. This interview took place at the 52nd Annual Meeting of the EBMT in Madrid, Spain.

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Transcript

So this is about the work that we have been doing for the last eight to nine years in Singapore. It involves the ex vivo T-cell depletion of a subset of T-cells called the alpha beta positive T-cells, which has been found to mediate graft versus host disease. So what we did was to collect the cells from the patient’s donor, which are all mismatched family donors...

So this is about the work that we have been doing for the last eight to nine years in Singapore. It involves the ex vivo T-cell depletion of a subset of T-cells called the alpha beta positive T-cells, which has been found to mediate graft versus host disease. So what we did was to collect the cells from the patient’s donor, which are all mismatched family donors. The cells are all subjected to ex vivo T-cell depletion to remove or to deplete the TCR alpha beta positive T-cells. So the intention is to deplete this subsets of cells, with the intention to decrease GVHD. And while doing that, we preserve some of the beneficial subsets of T-cells, like that of gamma delta T-cells, NK-cells, and also some of the important stem cells for engraftment. In addition, we also combine this with the upfront infusion of memory T-cells for the sake of transferring anti-infective immunity to patients, to promote engraftment and also to hasten immune reconstitution. So this protocol was designed for a few intentions. Number one, we offer it to mismatched donors from families because the ability to find the availability of a donor is subject to a little bit of genetic diversity and so on. And also, this protocol allows the transplant to be done with a very low risk of acute and chronic GVHD. And therefore, the patients are expected to live longer and also live without the burden of chronic GVHD. So that’s the main advantage of this protocol.

 

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