New findings from EBMT 2026 reveal autoantibodies do not reliably predict chronic graft versus host disease in pediatric patients but may reflect broader immune reconstitution patterns. Researchers analyzed 74 patients with acute lymphoblastic leukemia over eight years, detecting autoantibodies in 65% and anti-nuclear antibodies in 75%. Patients with autoantibodies showed improved immune recovery, with higher levels of T cells, B cells, and serum immunoglobulins.
Among patients with both autoantibodies and chronic graft versus host disease, immune alterations were evident, including expanded CD56 positive natural killer cells and increased CD21low B cells. Elevated CD21low B cells and CD56+ natural killer cells were linked to higher mortality, while improved survival correlated with lower natural killer cell levels and higher memory B cell levels.
Long-term immune recovery was observed in most survivors, with 89% showing normalization of the B cell compartment, including increased class switched CD27+IgD- B cells and higher immunoglobulin G4 levels.