Anti-thymocyte globulin-resistant CD4+ memory T cells contribute to haplo-fever after allogeneic hematopoietic stem cell transplantation
Year: 2026
Type: article
Study design: Observational Study
Abstract: Haplo-fever (HF) is a form of non-infectious fever that occurs shortly after haploidentical (HID) hematopoietic stem cell transplantation (HSCT). Its clinical significance, risk factors, and pathophysiology, particularly in the context of anti-thymocyte globulin (ATG)-based prophylaxis for graft-versus-host disease (GvHD), remain largely unknown. Here, we retrospectively analyzed clinical data from 143 consecutive HID HSCT recipients. Patients with HF exhibited a higher incidence of chronic GvHD, a lower risk of measurable residual disease recurrence, and improved event-free survival, particularly among those receiving ATG-based acute GvHD prophylaxis. Identified risk factors for HF included higher infused doses of CD34 + cells, mononucleated cells, CD3 + T cells, and CD4 + memory T cells. At 90 days post-transplant, patients with HF demonstrated elevated absolute numbers of CD4 + memory T cells and activated CD4 + and CD8 + T cells. RNA sequencing of peripheral blood CD3 + T cells at day 2 post-transplant revealed transcriptional signatures of T-cell activation and an abundance of activated CD4 + memory T cells as hallmarks of HF. Using multiple complementary approaches, we demonstrated the impact of HF on transplant outcomes, identified its risk factors, and elucidated the underlying cellular and molecular mechanisms.
Source: Blood Science
Institutions: Shanghai Jiao Tong University, Ruijin Hospital, Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, Chinese Academy of Medical Sciences & Peking Union Medical College, Institute of Hematology & Blood Diseases Hospital, State Key Laboratory of Experimental Hematology
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7131677945