Mature NK cells cultured in the presence of cytokines express markers such as HLA-DR

8 and NKp44 23 that were downregulated during progression of pre-NK cells to more mature developmental stages 19. Furthermore, CD56dim upregulate CD56 after activation by cytokines 24, downregulate CD16 after contact with target cells 25 and acquire receptors to home to lymph nodes after stimulation with IL-18 26. Hence, classifying BGB324 price activated NK cells by differentiation stage is cumbersome. This may be particularly so after HSC transplantation (HSCT) because cytokine levels in transplanted patients are often high 27–29. The majority of NK cells after HSCT are CD94+30, 31, express high levels of CD56 27–30, 32, 33, HLA-DR 32 and NKp44 34 and low levels of CCR7 29. This phenotype does not correspond to that of normal CD56bright in peripheral blood, CD56dim or to any of the early stages of NK-cell development. Nevertheless, post-transplant NK cells are often referred to as immature or less mature 29, check details 31, 32, 34. In this study,

we have compared NK cells at an early stage after graft take (defined as the first of two consecutive days that the transplanted HSC produced >0.5 Giga per liter (G/L) of granulocytes) with cytokine-stimulated CD56bright from peripheral blood of normal controls. We conclude that post-transplant CD56bright (ptCD56bright) NK cells are most likely to be mature CD56bright activated by the high level of cytokines present in the transplanted patient. We have characterized NK cells early (11±9 days) after graft take in 29 patients transplanted for hematological malignancies. All patients were in complete

remission and received no other immune suppression than the programmed, steroid-free graft-versus-host prophylaxis. At a moment that in most patients the transplanted HSC still produced a lower than normal number of granulocytes (median 2.8 G/L, range 0.35–11.5 G/L), NK cells (defined as CD3−CD56+ lymphocytes DOCK10 by the gates shown in Fig. 1A and B) had already reached normal or supranormal levels (0.25±0.13 G/L). This was mainly owed to the fact that the number of ptCD56bright (CD56brightCD16−/low, Fig. 1C) NK cells that represented the major subpopulation (51.6±23%) in the 29 patients studied was almost one log higher (0.134±0.11 G/L) than the number of CD56bright NK cells in the peripheral blood of normal individuals. Notably, the numbers of ptCD56bright and CD56dim (CD56dimCD16bright, Fig. 1C) were not correlated (Fig. 1D). We found no differences between patients receiving conditioning with (n=19) or without total body irradiation (n=5) or patients treated with reduced intensity regimens (n=5).