Impact of T cells on hematopoietic stem and progenitor cell function: Good guys or bad guys?

Abstract

When hematopoietic stem and progenitor cells (HSPC) are harvested for transplantation, either from the bone marrow or from mobilized blood, the graft contains a significant number of T cells. It is these T cells that are the major drivers of graft-vs-host disease (GvHD). The risk for GvHD can simply be reduced by the removal of these T cells from the graft. However, this is not always desirable, as this procedure also decreases the engraftment of the transplanted HSPCs and, if applicable, a graft-vs-tumor effect. This poses an important conundrum in the field: T cells act as a double-edged sword upon allogeneic HSPC transplantation, as they support engraftment of HSPCs and provide anti-tumor activity, but can also cause GvHD. It has recently been suggested that T cells also enhance the engraftment of autologous HSPCs, thus supporting the notion that T cells and HSPCs have an important functional interaction that is highly beneficial, in particular during transplantation. The underlying reason on why and how T cells contribute to HSPC engraftment is still poorly understood. Therefore, we evaluate in this review the studies that have examined the role of T cells during HSPC transplantation and the possible mechanisms involved in their supporting function. Understanding the underlying cellular and molecular mechanisms can provide new insight into improving HSPC engraftment and thus lower the number of HSPCs required during transplantation. Moreover, it could provide new avenues to limit the development of severe GvHD, thus making HSPC transplantations more efficient and ultimately safer.

Keywords: Hematopoietic stem cells, Hematopoietic stem and progenitor cells, CD8 T cells, Transplantation, Engraftment, Memory T cells, Facilitating cells, Bone marrow

Core tip: T cells act as a double-edged sword upon allogeneic hematopoietic stem and progenitor cells (HSPC) transplantation, as they support engraftment of HSPCs and provide anti-tumor activity, but are also the cause of graft-vs-host disease (GvHD). Here, we discuss the findings from several studies that have addressed the still enigmatic role of T cells during HSPC transplantation, either in an allogeneic or autologous setting, in mice or men, and with HSPCs derived from bone marrow, peripheral blood or cord blood. We anticipate that a better comprehension of how T cells support HSPC engraftment may lead to new strategies to optimize HSPCs transplantations and prevent GvHD.