Lethal GvHD in fully MHC-matched MCM post-allogeneic HSCT. a Longitudinal white blood cell (WBC), T cell, and platelet absolute counts in recipient macaques 33450 and 33455. Immune conditioning regimens are indicated in top panels (Bu = busulfan, Flu = fludarabine, TBI = total body irradiation, CD3-IT = CD3-immunotoxin). *Fludarabine was administered only to 33450. Colored circumflexes (^) indicate timepoints at which donor-derived cells were detected in whole blood by chimerism assays. Crosses (†) indicate time of necropsy. Normal WBC reference range = 5,600–18,4000/μl; normal platelet reference range = 134,000–564,000/μl. Shaded gray boxes in a, b indicate tacrolimus treatment period. b Longitudinal donor chimerism levels as measured by Illumina sequencing whole blood genomic DNA across SNPs differing between donor and recipient. Graphs display mean ± SEM frequencies of donor-derived cells as measured by two SNPs. c Longitudinal clinical GvHD scoring. Scoring criteria described in Methods section. d Multifocally extensive exfoliative dermatitis of thoracic limb of recipient macaque 33450. e Blinded tissue histopathology GvHD scoring at time of necropsy. Scoring criteria described in Methods section. f Tissue donor chimerism levels at time of necropsy as measured by Illumina sequencing genomic DNA across SNPs differing between donor and recipient. Graphs display mean ± SEM frequencies of donor-derived cells as measured by sequencing two SNPs. To eliminate non-immune cell contamination, colon, jejunum, and liver cell preparations were sorted for CD45+ cells prior to genomic DNA extraction. g Frequencies of Ki67+ T cells in tissues at time of necropsy, as determined by intracellular Ki67 flow cytometric staining. h Mixed lymphocyte reactions assessing levels of CD4+ and CD8+ T cell alloreactivity in recipient macaques 33450 and 33455 post-HSCT (at time of necropsy). Plots display proliferation of CFSE-labeled recipient T cells in response to irradiated donor or pre-HSCT recipient cells, as measured by frequency of CFSE-lo cells. Plots are gated on live, CD3+ singlets, and either CD4+ or CD8+ cells. Recipient cells cultured alone (no stim) or with SEB served as negative and positive controls, respectively.