{
  "abstract": "Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is potentially curative for many hematologic malignancies. Clinical outcomes are critically determined by the balance between graft-versus-malignancy effects and graft-versus-host disease (GvM and GvHD, respectively). We hypothesized that integrated immune phenotyping can distinguish immune tolerance from clinically relevant alloreactivity in patients with hematological neoplasia who are in remission after HSCT. These findings may have implications for GvHD screening and monitoring and could support treatment decision-making.\n\nMethods: Multi-color flow cytometry of peripheral blood mononuclear cells profiled myeloid, adaptive, and innate compartments in healthy donors ( n = 10) and post-HSCT patients in remission: without GvHD [NoGvHD ( n = 19)], with chronic (c) GvHD ( n = 18, including n = 4 overlap-a/cGvHD), and with acute (a) GvHD ( n = 6). Frequencies of immune cell subsets were compared between cohorts and stratified by clinical features [e.g., severity, organ involvement, donor lymphocyte infusion (DLI), GvHD development, and cGvHD progression].\n\nResults: NoGvHD patients (clinically asymptomatic and whose disease were in remission) showed immune-cell composition differing substantially from healthy donors: CD14 ⁺ monocytes (Mo), M-MDSCs, and especially checkpoint molecule (cpm)-expressing Mo (TIM3, 2B4, and PDL1) were reduced, while CTLA-4 ⁺ polymorphonuclear myeloid-derived suppressor cells (CTLA-4 ⁺ -PMN-MDSCs) were elevated, as well as T-effector memory (Tem) cells and cpm-expressing T cells (PD1, LAG3, 2B4, TIM3, and TIGIT). cGvHD showed eroded regulatory myeloid subsets and skewed T cells toward effector-memory dominance with increased frequencies of inhibitory cpm-expressing T cells. aGvHD showed marked late-proliferating T-cell expansion (T prol-late /T ³⁺ fold change 9.92 vs. Healthy), T reg depletion, and loss of regulatory NK 56bri populations. Overlap a/cGvHD displayed chronic T-cell stimulation with altered tissue homing (Intβ7 ⁺ enriched), and DLI-induced GvHD showed effector differentiation with insufficient regulatory compensation.\n\nConclusion: NoGvHD is not “Healthy minus disease” but a distinct post-HSCT immune state. Multi-compartment immune signature profiling by flow cytometry distinguishes preserved tolerance (Healthy) from post-HSCT remodeling (NoGvHD), progressive dysregulation (cGvHD), and acute hyperactivation (aGvHD), and refines GvHD subgroups by clinical context.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine III, University Hospital Ludwig-Maximilians-Universität (LMU) Munich",
    "Bavarian Cancer Research Center (BZKF)",
    "Faculty of Biology, University of Bielefeld",
    "Section for Stem Cell Transplantation and Cellular Therapy Research, Faculty of Medicine, University of Augsburg",
    "Comprehensive Cancer Center Alliance WERA (CCC WERA)",
    "Department of Internal Medicine II, University Hospital of Würzburg",
    "University of Bonn, University Hospital Bonn, Medical Clinic and Polyclinic III Internal Medicine with a focus on Oncology, Hematology, and Rheumatology",
    "Clinical Division of Hematology, Department of Internal Medicine, Medical University of Graz",
    "Department of Hematology and Oncology, University Hospital Ulm",
    "Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Vivien M. Simon"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Cansu Karatas"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Kristina Schreiner"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Anying Huang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Annalena Frischhut"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Joudi Abdulmajid"
    },
    {
      "affs": [
        1,
        3,
        4
      ],
      "name": "Christoph Schmid"
    },
    {
      "affs": [
        5
      ],
      "name": "Jochen J. Frietsch"
    },
    {
      "affs": [
        6
      ],
      "name": "Helene Schmeller"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Tobias A. W. Holderried"
    },
    {
      "affs": [
        8
      ],
      "name": "Elisa Sala"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Helga Schmetzer"
    },
    {
      "affs": [
        1,
        3,
        4
      ],
      "name": "Giuliano Filippini Velazquez"
    },
    {
      "affs": [
        9
      ],
      "name": "Jan Weller"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fdegbga90v6ys.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1934726",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1934726/full",
  "id": "fdegbga90v6ys",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1934726/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC581-607"
    ],
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7223332304",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1934726/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/fdegbga90v6ys.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:17Z",
      "native_id": "10.3389/fimmu.2026.1934726",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1934726/full"
    },
    {
      "first_seen": "2026-10-30T13:44:00Z",
      "native_id": "e4df4c2eb17f45f4a4fe0f0228d8e1c5",
      "source": "doaj",
      "url": "https://doi.org/10.3389/fimmu.2026.1934726"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    },
    {
      "field": "medicine",
      "origin": "lcc:RC581-607",
      "subfield": "general"
    }
  ],
  "title": "Composition of immune cells in peripheral blood of patients with leukemia in remission after stem cell transplantation (HSCT) with or without graft-versus-host disease (GvHD): a comparative analysis with healthy donors",
  "title_text": "Composition of immune cells in peripheral blood of patients with leukemia in remission after stem cell transplantation (HSCT) with or without graft-versus-host disease (GvHD): a comparative analysis with healthy donors",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:44:00Z",
  "url": "https://research.draconitic.com/paper/fdegbga90v6ys",
  "venue": "Frontiers in Immunology",
  "versions": []
}