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Dendritic Cell-Triggered Immune Activation Goes along with Provision of (Leukemia-Specific) Integrin Beta 7-Expressing Immune Cells and Improved Antileukemic Processes. Int J Mol Sci 2022; 24:ijms24010463. [PMID: 36613907 PMCID: PMC9820538 DOI: 10.3390/ijms24010463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Integrin beta 7 (β7), a subunit of the integrin receptor, is expressed on the surface of immune cells and mediates cell-cell adhesions and interactions, e.g., antitumor or autoimmune reactions. Here, we analyzed, whether the stimulation of immune cells by dendritic cells (of leukemic derivation in AML patients or of monocyte derivation in healthy donors) leads to increased/leukemia-specific β7 expression in immune cells after T-cell-enriched mixed lymphocyte culture-finally leading to improved antileukemic cytotoxicity. Healthy, as well as AML and MDS patients' whole blood (WB) was treated with Kit-M (granulocyte-macrophage colony-stimulating factor (GM-CSF) + prostaglandin E1 (PGE1)) or Kit-I (GM-CSF + Picibanil) in order to generate DCs (DCleu or monocyte-derived DC), which were then used as stimulator cells in MLC. To quantify antigen/leukemia-specific/antileukemic functionality, a degranulation assay (DEG), an intracellular cytokine assay (INTCYT) and a cytotoxicity fluorolysis assay (CTX) were used. (Leukemia-specific) cell subtypes were quantified via flow cytometry. The Kit treatment of WB (compared to the control) resulted in the generation of DC/DCleu, which induced increased activation of innate and adaptive cells after MLC. Kit-pretreated WB (vs. the control) led to significantly increased frequencies of β7-expressing T-cells, degranulating and intracellular cytokine-producing β7-expressing immune cells and, in patients' samples, increased blast lysis. Positive correlations were found between the Kit-M-mediated improvement of blast lysis (vs. the control) and frequencies of β7-expressing T-cells. Our findings indicate that DC-based immune therapies might be able to specifically activate the immune system against blasts going along with increased frequencies of (leukemia-specific) β7-expressing immune cells. Furthermore, β7 might qualify as a predictor for the efficiency and the success of AML and/or MDS therapies.
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Odak I, Sikora R, Riemann L, Bayir LM, Beck M, Drenker M, Xiao Y, Schneider J, Dammann E, Stadler M, Eder M, Ganser A, Förster R, Koenecke C, Schultze-Florey CR. Spectral flow cytometry cluster analysis of therapeutic donor lymphocyte infusions identifies T cell subsets associated with outcome in patients with AML relapse. Front Immunol 2022; 13:999163. [PMID: 36275657 PMCID: PMC9579313 DOI: 10.3389/fimmu.2022.999163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Identification of immune phenotypes linked to durable graft-versus-leukemia (GVL) response following donor lymphocyte infusions (DLI) is of high clinical relevance. In this prospective observational study of 13 AML relapse patients receiving therapeutic DLI, we longitudinally investigated changes in differentiation stages and exhaustion markers of T cell subsets using cluster analysis of 30-color spectral flow cytometry during 24 months follow-up. DLI cell products and patient samples after DLI were analyzed and correlated to the clinical outcome. Analysis of DLI cell products revealed heterogeneity in the proportions of naïve and antigen experienced T cells. Cell products containing lower levels of effector memory (eff/m) cells and higher amounts of naïve CD4+ and CD8+ T cells were associated with long-term remission. Furthermore, investigation of patient blood samples early after DLI showed that patients relapsing during the study period, had higher levels of CD4+ eff/m T cells and expressed a mosaic of surface molecules implying an exhausted functional state. Of note, this observation preceded the clinical diagnosis of relapse by five months. On the other hand, patients with continuous remission retained lower levels of exhausted CD4+ eff/m T cells more than four months post DLI. Moreover, lower frequencies of exhausted CD8+ eff/m T cells as well as higher amounts of CD4+temra CD45RO+ T cells were present in this group. These results imply the formation of functional long-term memory pool of T cells. Finally, unbiased sample analysis showed that DLI cell products with low levels of eff/m cells both in CD4+ and CD8+ T cell subpopulations associate with a lower relapse incidence. Additionally, competing risk analysis of patient samples taken early after DLI revealed that patients with high amounts of exhausted CD4+ eff/m T cells in their blood exhibited significantly higher rates of relapse. In conclusion, differentially activated T cell clusters, both in the DLI product and in patients post infusion, were associated with AML relapse after DLI. Our study suggests that differences in DLI cell product composition might influence GVL. In-depth monitoring of T cell dynamics post DLI might increase safety and efficacy of this immunotherapy, while further studies are needed to assess the functionality of T cells found in the DLI.
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Affiliation(s)
- Ivan Odak
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- *Correspondence: Christian R. Schultze-Florey, ; Ivan Odak,
| | - Ruth Sikora
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Lennart Riemann
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Lâle M. Bayir
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Maleen Beck
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Melanie Drenker
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Yankai Xiao
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Jessica Schneider
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Elke Dammann
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Michael Stadler
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Matthias Eder
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Reinhold Förster
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Christian Koenecke
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Christian R. Schultze-Florey
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
- *Correspondence: Christian R. Schultze-Florey, ; Ivan Odak,
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Hematopoietic Cell Transplantation in the Treatment of Pediatric Acute Myelogenous Leukemia and Myelodysplastic Syndromes: Guidelines from the American Society of Transplantation and Cellular Therapy. Transplant Cell Ther 2022; 28:530-545. [DOI: 10.1016/j.jtct.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/20/2022]
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Kang S, Li Y, Qiao J, Meng X, He Z, Gao X, Yu L. Antigen-Specific TCR-T Cells for Acute Myeloid Leukemia: State of the Art and Challenges. Front Oncol 2022; 12:787108. [PMID: 35356211 PMCID: PMC8959347 DOI: 10.3389/fonc.2022.787108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/10/2022] [Indexed: 12/16/2022] Open
Abstract
The cytogenetic abnormalities and molecular mutations involved in acute myeloid leukemia (AML) lead to unique treatment challenges. Although adoptive T-cell therapies (ACT) such as chimeric antigen receptor (CAR) T-cell therapy have shown promising results in the treatment of leukemias, especially B-cell malignancies, the optimal target surface antigen has yet to be discovered for AML. Alternatively, T-cell receptor (TCR)-redirected T cells can target intracellular antigens presented by HLA molecules, allowing the exploration of a broader territory of new therapeutic targets. Immunotherapy using adoptive transfer of WT1 antigen-specific TCR-T cells, for example, has had positive clinical successes in patients with AML. Nevertheless, AML can escape from immune system elimination by producing immunosuppressive factors or releasing several cytokines. This review presents recent advances of antigen-specific TCR-T cells in treating AML and discusses their challenges and future directions in clinical applications.
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Affiliation(s)
- Synat Kang
- Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center, Shenzhen, China
| | - Yisheng Li
- Central Laboratory, Shenzhen University General Hospital, Shenzhen, China
| | - Jingqiao Qiao
- Central Laboratory, Shenzhen University General Hospital, Shenzhen, China
| | - Xiangyu Meng
- Central Laboratory, Shenzhen University General Hospital, Shenzhen, China
| | - Ziqian He
- Central Laboratory, Shenzhen University General Hospital, Shenzhen, China
| | - Xuefeng Gao
- Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center, Shenzhen, China.,Central Laboratory, Shenzhen University General Hospital, Shenzhen, China
| | - Li Yu
- Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center, Shenzhen, China
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Trial Watch: Adoptive TCR-Engineered T-Cell Immunotherapy for Acute Myeloid Leukemia. Cancers (Basel) 2021; 13:cancers13184519. [PMID: 34572745 PMCID: PMC8469736 DOI: 10.3390/cancers13184519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/20/2021] [Accepted: 09/01/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Acute myeloid leukemia (AML) is a type of blood cancer with an extremely grim prognosis. This is due to the fact that the majority of patients will relapse after frontline treatment. Overall survival of relapsed AML is very low, and treatment options are few. T lymphocytes harnessed with antitumor T-cell receptors (TCRs) can produce objective clinical responses in certain cancers, such as melanoma, but have not entered the main road for AML. In this review, we describe the current status of the field of TCR-T-cell therapies for AML. Abstract Despite the advent of novel therapies, acute myeloid leukemia (AML) remains associated with a grim prognosis. This is exemplified by 5-year overall survival rates not exceeding 30%. Even with frontline high-intensity chemotherapy regimens and allogeneic hematopoietic stem cell transplantation, the majority of patients with AML will relapse. For these patients, treatment options are few, and novel therapies are urgently needed. Adoptive T-cell therapies represent an attractive therapeutic avenue due to the intrinsic ability of T lymphocytes to recognize tumor cells with high specificity and efficiency. In particular, T-cell therapies focused on introducing T-cell receptors (TCRs) against tumor antigens have achieved objective clinical responses in solid tumors such as synovial sarcoma and melanoma. However, contrary to chimeric antigen receptor (CAR)-T cells with groundbreaking results in B-cell malignancies, the use of TCR-T cells for hematological malignancies is still in its infancy. In this review, we provide an overview of the status and clinical advances in adoptive TCR-T-cell therapy for the treatment of AML.
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Abstract
The outcomes associated with pediatric acute myeloid leukemia (AML) have improved over the last few decades, with the implementation of intensive chemotherapy, hematopoietic stem cell transplant, and improved supportive care. However, even with intensive therapy and the use of HSCT, both of which carry significant risks of short- and long-term side effects, approximately 30% of children are not able to be cured. The characterization of AML in pediatrics has evolved over time and it currently involves use of a variety of diagnostic tools, including flow cytometry and comprehensive genomic sequencing. Given the adverse effects of chemotherapy and the need for additional therapeutic options to improve outcomes in these patients, the genomic and molecular architecture is being utilized to inform selection of targeted therapies in pediatric AML. This review provides a summary of current, targeted therapy options in pediatric AML.
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Potential of immunotherapies in the mediation of antileukemic responses for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) - With a focus on Dendritic cells of leukemic origin (DC leu). Clin Immunol 2020; 217:108467. [PMID: 32464186 DOI: 10.1016/j.clim.2020.108467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/11/2020] [Accepted: 05/16/2020] [Indexed: 11/23/2022]
Abstract
New (non-immunotherapeutic) treatment-strategies for AML/MDS-patients are under development. Dendritic cells (DCs) and 'leukemia-derived DC' (DCleu) connect the innate and the adaptive immunesystem and (re-)activate it, in their capacity as professional antigen-presenting cells (APCs). They can be generated ex vivo from peripheral blood mononuclear cells (PBMNCs) or whole blood (WB), containing the -physiological-cellular/soluble microenvironment of individual patients using various DC/DCleu-generating methods or (for WB) minimalized 'Kits', containing granulocyte-macrophage-colony-stimulating-factor (GM-CSF) and a second response-modifier. Proof for DC/DCleu-mediated activation of the immune-system after T-cell-enriched mixed lymphocyte culture (MLC) is done by flowcytometry, demonstrating increased fractions of certain activated, leukemia-specific or antileukemic cell-subsets of the innate and the adaptive immune-system. Generation of DC/DCleu is possible independent of patients' age, MHC-, mutation- or transplantation-status. In vivo-treatment of AML-/MDS-patients with blast-modulating, DC/DCleu- inducing 'Kits' could contribute to create migratory DCs, as well as antileukemically reactivated and memory-mediating immune-cells, which patrol tissue and blood and could contribute to stabilizing disease or remissions.
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Biernacki MA, Sheth VS, Bleakley M. T cell optimization for graft-versus-leukemia responses. JCI Insight 2020; 5:134939. [PMID: 32376800 DOI: 10.1172/jci.insight.134939] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Protection from relapse after allogeneic hematopoietic cell transplantation (HCT) is partly due to donor T cell-mediated graft-versus-leukemia (GVL) immune responses. Relapse remains common in HCT recipients, but strategies to augment GVL could significantly improve outcomes after HCT. Donor T cells with αβ T cell receptors (TCRs) mediate GVL through recognition of minor histocompatibility antigens and alloantigens in HLA-matched and -mismatched HCT, respectively. αβ T cells specific for other leukemia-associated antigens, including nonpolymorphic antigens and neoantigens, may also deliver an antileukemic effect. γδ T cells may contribute to GVL, although their biology and specificity are less well understood. Vaccination or adoptive transfer of donor-derived T cells with natural or transgenic receptors are strategies with potential to selectively enhance αβ and γδ T cell GVL effects.
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Affiliation(s)
- Melinda A Biernacki
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Medicine, and
| | - Vipul S Sheth
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Marie Bleakley
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
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Muñoz Builes M, Vela Cuenca M, Fuster Soler JL, Astigarraga I, Pascual Martínez A, Vagace Valero JM, Tong HY, Valentín Quiroga J, Fernández Casanova L, Escudero López A, Sisinni L, Blanquer M, Mirones Aguilar I, González Martínez B, Borobia AM, Pérez-Martínez A. Study protocol for a phase II, multicentre, prospective, non-randomised clinical trial to assess the safety and efficacy of infusing allogeneic activated and expanded natural killer cells as consolidation therapy for paediatric acute myeloblastic leukaemia. BMJ Open 2020; 10:e029642. [PMID: 31919123 PMCID: PMC6955478 DOI: 10.1136/bmjopen-2019-029642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Acute myeloblastic leukaemia (AML) constitutes the second most common haematological malignancy in the paediatric population. Current treatment regimens are based on the administration of polychemotherapy, combining high doses of cytarabine with anthracyclines and topoisomerase inhibitors. Allogeneic haematopoietic stem cell transplantation (HSCT) is an option for high-risk patients with AML (and for intermediate-risk patients if a sibling donor is available). With this strategy, AML survival has increased substantially; however, it has remained stagnant at approximately 60%, with relapse being the principal culprit. The predominant role of the immune system and natural killer (NK) cells in controlling paediatric AML has gained importance within the context of HSCT. In this protocol, we propose incorporating this cell therapy as an adjuvant treatment through the infusion of activated and expanded haploidentical NK (NKAE) cells in paediatric patients with AML who are in cytological remission after completing consolidation therapy, and with no indication for HSCT. METHODS AND ANALYSIS Patients up to 30 years of age, diagnosed with AML, in their first cytological remission, who have completed both the induction and the consolidation phases of chemotherapy and do not meet the criteria for allogeneic HSCT are eligible. The patients will receive two doses of NKAE cells once a week, using a GMP K562-mbIL15-41BBL stimulus from a haploidentical donor and interleukin 2 subcutaneously. The patients will then be followed up for 36 months to assess the primary endpoint, which is the probability of relapse after NK cell infusion. ETHICS AND DISSEMINATION This clinical trial was approved by the Clinical Research Ethics Committee of La Paz University Hospital and The Spanish Agency of Medicines and Medical Devices. Findings will be disseminated through peer-reviewed publications, conference presentations and community reporting. TRIAL REGISTRATION NUMBER EudraCT code: 2015-001901-15, ClinicalTrials.gov Identifier: NCT02763475.
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Affiliation(s)
- Mario Muñoz Builes
- La Paz Central Research and Clinical Trials Unit, Hospital Universitario La Paz, Madrid, Spain
| | - María Vela Cuenca
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
| | - Jose L Fuster Soler
- Paediatric Haematology-Oncology Unit, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
| | - Itziar Astigarraga
- Department of Paediatrics, Hospital Universitario Cruces, Barakaldo, Spain
| | - Antonia Pascual Martínez
- Paediatric Haematology Unit, Maternal and Children Hospital, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Jose M Vagace Valero
- Paediatric Haematology Department, Maternal and Children Hospital, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - Hoi Y Tong
- La Paz Central Research and Clinical Trials Unit, Hospital Universitario La Paz, Madrid, Spain
| | - Jaime Valentín Quiroga
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
| | - Lucía Fernández Casanova
- Haematological Malignancies Clinical Research Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Adela Escudero López
- Translational Research Unit in Paediatric Hemato-Oncology, Haematopoietic Stem Cell Transplantation and Cell Therapy, Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, Madrid, Spain
| | - Luisa Sisinni
- Paediatric Haemato-Oncology Deparment, Hospital Universitario La Paz, Madrid, Spain
| | - Miguel Blanquer
- Paediatric Haematology-Oncology Unit, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
| | - Isabel Mirones Aguilar
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
| | - Berta González Martínez
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
- Paediatric Haemato-Oncology Deparment, Hospital Universitario La Paz, Madrid, Spain
| | - Alberto M Borobia
- Clinical Pharmacology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Antonio Pérez-Martínez
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
- Paediatric Haemato-Oncology Deparment, Hospital Universitario La Paz, Madrid, Spain
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Inhibition of Heme Oxygenase-1 Activity Enhances Wilms Tumor-1-Specific T-Cell Responses in Cancer Immunotherapy. Int J Mol Sci 2019; 20:ijms20030482. [PMID: 30678050 PMCID: PMC6387130 DOI: 10.3390/ijms20030482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 02/07/2023] Open
Abstract
Wilms tumor protein-1 (WT1) is an attractive target for adoptive T-cell therapy due to its expression in solid tumors and hematologic malignancies. However, T cells recognizing WT1 occur in low frequencies in the peripheral blood of healthy donors, limiting potential therapeutic possibilities. Tin mesoporphyrin (SnMP) is known to inhibit heme oxygenase-1 (HO-1), which has been shown to boost the activation and proliferation of human virus-specific T cells. We analyzed the influence of this effect on the generation of WT1-specific T cells and developed strategies for generating quantities of these cells from healthy donors, sufficient for adoptive T-cell therapies. HO-1 inhibition with SnMP increased WT1-specific T-cell frequencies in 13 (26%) of 50 healthy donors. To assess clinical applicability, we measured the enrichment efficiency of SnMP-treated WT1-specific T cells in response to a WT1-specific peptide pool and a HLA-A*02:01-restricted WT1 peptide by cytokine secretion assay. SnMP treatment resulted in a 28-fold higher enrichment efficacy with equal functionality. In conclusion, pharmacological inhibition of HO-1 activity with SnMP results in more efficient generation of functionally active WT1-specific T cells. This study demonstrates the therapeutic potentials of inhibiting HO-1 with SnMP to enhance antigen-specific T-cell responses in the treatment of cancer patients with WT1-positive disease.
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Matko S, Manderla J, Bonsack M, Schmitz M, Bornhauser M, Tonn T, Odendahl M. PRAME peptide-specific CD8 + T cells represent the predominant response against leukemia-associated antigens in healthy individuals. Eur J Immunol 2018; 48:1400-1411. [PMID: 29738081 DOI: 10.1002/eji.201747399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 04/10/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Abstract
Antigen-specific T cells isolated from healthy individuals (HIs) have shown great therapeutic potential upon adoptive transfer for the treatment of viremia in immunosuppressed patients. The lack of comprehensive data on the prevalence and characteristics of leukemia-associated antigen (LAA)-specific T cells in HIs still limits such an approach for tumor therapy. Therefore, we have investigated T-cell responses against prominent candidates comprising Wilms' tumor protein 1 (WT1), preferentially expressed antigen in melanoma (PRAME), Survivin, NY-ESO, and p53 by screening PBMCs from HIs using intracellular IFN-γ staining following provocation with LAA peptide mixes. Here, we found predominantly poly-functional effector/effector memory CCR7- /CD45RA+/- /CD8+ LAA peptide-specific T cells with varying CD95 expression in 34 of 100 tested HIs, whereas CD4+ T cells responses were restricted to 5. Most frequent LAA peptide-specific T cell responses were directed against WT1 and PRAME peptides with a prevalence of 20 and 17%, respectively, showing the highest magnitude (0.16% ± 0.22% (mean ± SD)) for PRAME peptides. Cytotoxicity of PRAME peptide-specific T cells was demonstrated by specific killing of PRAME peptide-pulsed T2 cells. Furthermore, the proliferative capacity of PRAME peptide-specific T cells was confined to HIs responsive toward PRAME peptide challenge corroborating the accuracy of the screening results. In conclusion, we identified PRAME as a promising target antigen for adoptive leukemia therapy.
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Affiliation(s)
- Sarah Matko
- Experimental Transfusion Medicine, Medical Faculty Carl Gustav Carus, TU Dresden, Germany.,Institute for Transfusion Medicine Dresden, German Red Cross Blood Donation Service North-East, Dresden, Germany
| | - Julia Manderla
- Experimental Transfusion Medicine, Medical Faculty Carl Gustav Carus, TU Dresden, Germany.,Institute for Transfusion Medicine Dresden, German Red Cross Blood Donation Service North-East, Dresden, Germany
| | - Maria Bonsack
- Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - Marc Schmitz
- Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany.,German Cancer Research Center (DKFZ) partner site Dresden; and German Cancer Consortium (DKTK), Heidelberg, Germany.,Institute of Immunology, Medical Faculty, TU Dresden, Dresden, Germany.,National Center for Tumor Diseases, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Martin Bornhauser
- Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany.,German Cancer Research Center (DKFZ) partner site Dresden; and German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Medicine 1, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.,National Center for Tumor Diseases, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Torsten Tonn
- Experimental Transfusion Medicine, Medical Faculty Carl Gustav Carus, TU Dresden, Germany.,Institute for Transfusion Medicine Dresden, German Red Cross Blood Donation Service North-East, Dresden, Germany.,Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany.,German Cancer Research Center (DKFZ) partner site Dresden; and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Marcus Odendahl
- Experimental Transfusion Medicine, Medical Faculty Carl Gustav Carus, TU Dresden, Germany.,Institute for Transfusion Medicine Dresden, German Red Cross Blood Donation Service North-East, Dresden, Germany
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Driss V, Leprêtre F, Briche I, Mopin A, Villenet C, Figeac M, Quesnel B, Brinster C. Sub-clonal analysis of the murine C1498 acute myeloid leukaemia cell line reveals genomic and immunogenic diversity. Immunol Lett 2017; 192:27-34. [PMID: 29030252 DOI: 10.1016/j.imlet.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/09/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND In acute myeloid leukaemia (AML)-affected patients, the presence of heterogeneous sub-clones at diagnosis has been shown to be responsible for minimal residual disease and relapses. The role played by the immune system in this leukaemic sub-clonal hierarchy and maintenance remains unknown. As leukaemic sub-clone immunogenicity could not be evaluated in human AML xenograft models, we assessed the sub-clonal diversity of the murine C1498 AML cell line and the immunogenicity of its sub-clones in immune-competent syngeneic mice. METHODOLOGY The murine C1498 cell line was cultured in vitro and sub-clonal cells were generated after limiting dilution. The genomic profiles of 6 different sub-clones were analysed by comparative genomic hybridization arrays (CGH). The sub-clones were then injected into immune-deficient and - competent syngeneic mice. The immunogenicities of the sub-clones was evaluated through 1) assessment of mouse survival, 2) determination of leukaemic cell infiltration into organs by flow cytometry and the expression of a fluorescent reporter gene, 3) assessment of the CTL response ex vivo and 4) detection of residual leukaemic cells in the organs via amplification of the genomic reporter gene by real-time PCR (qPCR). RESULTS Genomic analyses revealed heterogeneity among the parental cell line and its derived sub-clones. When injected individually into immune-deficient mice, all sub-clones induced cases of AML with different kinetics. However, when administered into immune-competent animals, some sub-clones triggered AML in which no mice survived, whereas others elicited reduced lethality rates. The AML-surviving mice presented efficient anti-leukaemia CTL activity ex vivo and eliminated the leukaemic cells in vivo. CONCLUSION We showed that C1498 cell sub-clones presented genomic heterogeneity and differential immunogenicity resulting either in immune escape or elimination. Such findings could have potent implications for new immunotherapeutic strategies in patients with AML.
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Affiliation(s)
- Virginie Driss
- INSERM UMR-S-1172, Centre de Recherche Jean-Pierre Aubert (JPARC), France; Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France.
| | - Frédéric Leprêtre
- Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France; IFR 114, IMPRT, Institut de Médecine Prédictive et de Recherche Thérapeutique, plate-forme génomique fonctionnelle et structurale, France; Université de Lille, Lille, France.
| | - Isabelle Briche
- INSERM UMR-S-1172, Centre de Recherche Jean-Pierre Aubert (JPARC), France; Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France.
| | - Alexia Mopin
- INSERM UMR-S-1172, Centre de Recherche Jean-Pierre Aubert (JPARC), France; Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France; CHU Lille (Centre Hospitalier Universitaire de Lille), Service des Maladies du Sang, F-59000 Lille, France.
| | - Céline Villenet
- Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France; IFR 114, IMPRT, Institut de Médecine Prédictive et de Recherche Thérapeutique, plate-forme génomique fonctionnelle et structurale, France; Université de Lille, Lille, France
| | - Martin Figeac
- Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France; IFR 114, IMPRT, Institut de Médecine Prédictive et de Recherche Thérapeutique, plate-forme génomique fonctionnelle et structurale, France; Université de Lille, Lille, France.
| | - Bruno Quesnel
- INSERM UMR-S-1172, Centre de Recherche Jean-Pierre Aubert (JPARC), France; Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France; CHU Lille (Centre Hospitalier Universitaire de Lille), Service des Maladies du Sang, F-59000 Lille, France.
| | - Carine Brinster
- INSERM UMR-S-1172, Centre de Recherche Jean-Pierre Aubert (JPARC), France; Institut pour la Recherche sur le Cancer de Lille (IRCL), 1, place de verdun, 59045 Lille Cedex, France; Université de Lille, Lille, France.
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Dickinson AM, Norden J, Li S, Hromadnikova I, Schmid C, Schmetzer H, Jochem-Kolb H. Graft-versus-Leukemia Effect Following Hematopoietic Stem Cell Transplantation for Leukemia. Front Immunol 2017. [PMID: 28638379 PMCID: PMC5461268 DOI: 10.3389/fimmu.2017.00496] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The success of hematopoietic stem cell transplantation (HSCT) lies with the ability of the engrafting immune system to remove residual leukemia cells via a graft-versus-leukemia effect (GvL), caused either spontaneously post-HSCT or via donor lymphocyte infusion. GvL effects can also be initiated by allogenic mismatched natural killer cells, antigen-specific T cells, and activated dendritic cells of leukemic origin. The history and further application of this GvL effect and the main mechanisms will be discussed and reviewed in this chapter.
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Affiliation(s)
- Anne M Dickinson
- Haematological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Jean Norden
- Haematological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Shuang Li
- Third Faculty of Medicine, Department of Molecular Biology and Cell Pathology, Charles University, Prague, Czechia
| | - Ilona Hromadnikova
- Third Faculty of Medicine, Department of Molecular Biology and Cell Pathology, Charles University, Prague, Czechia
| | - Christoph Schmid
- Department for Hematopoietic Cell Transplantation, University Hospital Augsburg, Munich, Germany
| | - Helga Schmetzer
- Department for Hematopoietic Cell Transplantation, Internal Medicine III, Hospital of the University of Munich, Munich, Germany
| | - Hans Jochem-Kolb
- Department of Hematology-Oncology Immunology Infectious Diseases, Klinikum München-Schwabing, Munich, Germany
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14
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Kolb HJ. Hematopoietic stem cell transplantation and cellular therapy. HLA 2017; 89:267-277. [DOI: 10.1111/tan.13005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 01/08/2023]
Affiliation(s)
- H.-J. Kolb
- Helmholtz Zentrum Muenchen; Muenchen Germany
- Ludwig Maximilians Universitaet Muenchen; Muenchen Germany
- Klinikum Muenchen Schwabing Muenchen; Muenchen Germany
- Department PediatricsTechnische Unoiversitaet Muenchen; Muenchen Germany
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15
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Rücker-Braun E, Link CS, Schmiedgen M, Tunger A, Vizjak P, Teipel R, Wehner R, Kühn D, Fuchs YF, Oelschlägel U, Germeroth L, Schmitz M, Bornhäuser M, Schetelig J, Heidenreich F. Longitudinal analyses of leukemia-associated antigen-specific CD8 + T cells in patients after allogeneic stem cell transplantation. Exp Hematol 2016; 44:1024-1033.e1. [PMID: 27473564 DOI: 10.1016/j.exphem.2016.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/30/2016] [Accepted: 07/15/2016] [Indexed: 10/21/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment approach for patients with acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL). Graft versus leukemia (GVL) effects, which are exerted by donor T cells directed against leukemic-associated antigens (LAAs), are considered to play a crucial role in disease eradication. Although the expansion of cytotoxic T lymphocytes (CTLs) specific for cytomegalovirus (CMV) in response to an infection has been shown in multiple studies, data on CTLs mediating GVL effects are limited. To evaluate a potential increase or decrease of T lymphocytes specific for LAAs in the setting of allogeneic HSCT, we monitored leukemia-specific CD8+ T cells throughout the first year after HSCT in 18 patients using streptamer technology. A broad panel of promising LAAs was selected: Wilms tumor protein, proteinase 3, receptor for hyaluronan acid-mediated motility, apoptosis regulator Bcl-2, survivin, nucleophosmin, and fibromodulin. T cells specifically directed against AML- or CLL-associated antigens were found at very low frequencies in peripheral blood. Substantial frequencies of LAA-specific T cells could not be measured at any time point by flow cytometry. In contrast, abundant CMV-pp65-specific T cells were detected in CMV-seropositive patient-recipient pairs and an increase prompted by CMV infection could be demonstrated. In conclusion, T lymphocytes with specificities for the aforementioned LAAs can only be detected in minimal quantities in the early phase after allogeneic HSCT.
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Affiliation(s)
- Elke Rücker-Braun
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
| | - Cornelia S Link
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; Deutsche Forschungsgemeinschaft Research Center for Regenerative Therapies Dresden, Medical Faculty, TU Dresden, Dresden, Germany
| | - Maria Schmiedgen
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Antje Tunger
- Institute of Immunology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Petra Vizjak
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Raphael Teipel
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Rebekka Wehner
- Institute of Immunology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; National Center for Tumor Diseases, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Denise Kühn
- Deutsche Forschungsgemeinschaft Research Center for Regenerative Therapies Dresden, Medical Faculty, TU Dresden, Dresden, Germany
| | - Yannik F Fuchs
- Deutsche Forschungsgemeinschaft Research Center for Regenerative Therapies Dresden, Medical Faculty, TU Dresden, Dresden, Germany
| | - Uta Oelschlägel
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Marc Schmitz
- Deutsche Forschungsgemeinschaft Research Center for Regenerative Therapies Dresden, Medical Faculty, TU Dresden, Dresden, Germany; Institute of Immunology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; National Center for Tumor Diseases, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Martin Bornhäuser
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; Deutsche Forschungsgemeinschaft Research Center for Regenerative Therapies Dresden, Medical Faculty, TU Dresden, Dresden, Germany
| | - Johannes Schetelig
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; DKMS, German Bone Marrow Donor Center, Tübingen, Germany
| | - Falk Heidenreich
- Medical Clinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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16
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Finke J, Schmoor C, Bertz H, Marks R, Wäsch R, Zeiser R, Hackanson B. Long-term follow-up of therapy-related myelodysplasia and AML patients treated with allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2016; 51:771-7. [PMID: 26752137 DOI: 10.1038/bmt.2015.338] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/11/2015] [Accepted: 12/01/2015] [Indexed: 12/18/2022]
Abstract
The outcome of patients with therapy-related myelodysplasia (t-MDS) or t-AML is very poor. The only curative treatment option implements allogeneic hematopoietic cell transplantation (aHCT); however, long-term follow-up data beyond 5 years are scarce. Here we report on a cohort of 79 consecutive patients with a median age of 58 years (range (r): 20-76) at transplantation and a median follow-up of 7.5 years (r: 0.07-19.0). Only 19 (24.1%) patients were in CR before aHCT. Non-relapse mortality and relapse rates were 23% (95% confidence interval, 15-35%) and 42% (32-55%) at 5 years, and 32% (22-46%) and 44% (34-57%) at 10 years, respectively. Disease-free survival (DFS) and overall survival (OS) rates were 35% (24-46%) and 38% (27-49%) at 5 years, and 24% (14-36%) and 24% (13-36%) at 10 years, respectively. Although cytogenetic aberrations were associated with shorter DFS and higher relapse risk, persistent disease at the time of transplantation, an unrelated donor and patient age were not associated with shorter OS. In conclusion, long-term survival beyond 10 years of t-MDS/t-AML patients after aHCT is possible, even for refractory patients. Therefore, early donor search and rapid transplantation are warranted, also to decrease the risk of disease-related deterioration of patients' performance status.
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Affiliation(s)
- J Finke
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - C Schmoor
- Center for Clinical Trials and Biostatistics, University Medical Center, Freiburg, Germany
| | - H Bertz
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - R Marks
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - R Wäsch
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - R Zeiser
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - B Hackanson
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
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