PD-1/TIM-3-Expressing Myeloid Cells During the Early Immune Reconstitution in Patients with Multiple Myeloma After High-Dose Chemotherapy

Immunol Invest. 2026 Jan;55(1):18-40. doi: 10.1080/08820139.2025.2568871. Epub 2025 Oct 4.

Abstract

Background: In multiple myeloma (MM), immune checkpoint blockade is being explored as a treatment strategy. However, the role of inhibitory checkpoint receptors on myeloid cells remains poorly understood. The aim of our study was to investigate the expression of PD-1 and TIM-3 on monocytes and monocytic myeloid-derived suppressor cells (M-MDSCs) and their contribution to early immune reconstitution.

Methods: The count of monocytic cells and expression of PD-1 and TIM-3 was assessed by flow cytometry.

Results: At the engraftment, monocyte subsets counts were similar to pre-transplant values, while the relative content of M-MDSCs was significantly higher. The frequencies of TIM-3-positive cells among intermediate and non-classical monocytes were significantly increased. Incubation of mononuclear cells of MM patients in remission with homeostatic cytokines led to a significant increase in intermediate monocytes and a trend to an increase in the M-MDSCs count and stimulated the expression of PD-1 and TIM-3. PD-1 and TIM-3 expression on monocytes and M-MDSCs inversely correlated with lymphocyte count at the engraftment. TIM-3 expression on monocytic cells was associated with regulatory T-cell count. After auto-HSCT, PD-1/TIM-3-expressing cells exhibited significantly elevated IL-10 production (with decreased TNFα production).

Conclusion: PD-1 and TIM-3 on monocytic cells may play a significant role in immune reconstitution.

Keywords: Immune reconstitution; Inhibitory checkpoint receptors; monocytes; multiple myeloma; myeloid-derived suppressor cells.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Hepatitis A Virus Cellular Receptor 2* / metabolism
  • Humans
  • Immune Reconstitution*
  • Male
  • Middle Aged
  • Monocytes* / immunology
  • Monocytes* / metabolism
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / immunology
  • Multiple Myeloma* / metabolism
  • Multiple Myeloma* / therapy
  • Myeloid-Derived Suppressor Cells* / immunology
  • Myeloid-Derived Suppressor Cells* / metabolism
  • Programmed Cell Death 1 Receptor* / metabolism
  • T-Lymphocytes, Regulatory / immunology

Substances

  • Hepatitis A Virus Cellular Receptor 2
  • Programmed Cell Death 1 Receptor
  • HAVCR2 protein, human
  • PDCD1 protein, human