1
|
Przespolewski AC, Griffiths EA. FLT3-mutated acute myeloid leukaemia: a new opportunity. Lancet 2023; 401:1546-1548. [PMID: 37116522 DOI: 10.1016/s0140-6736(23)00617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/30/2023]
|
2
|
Przespolewski AC, Portwood S, Wang ES. Targeting acute myeloid leukemia through multimodal immunotherapeutic approaches. Leuk Lymphoma 2022; 63:918-927. [PMID: 34818963 PMCID: PMC10691526 DOI: 10.1080/10428194.2021.1992614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 10/04/2021] [Indexed: 10/19/2022]
Abstract
Acute myeloid leukemia (AML) is an aggressive hematologic malignancy with a dismal prognosis. Immunotherapeutic approaches using single agent checkpoint inhibitors have thus far shown limited success. We hypothesized that successful adaptive anti-AML specific immune responses require additional modulation of innate immunity. DMXAA exposure resulted in modest apoptosis of C1498 AML cells with a subtle increase in PD-L1 expression and limited production of IL-6 and IFN-β. In contrast, DMXAA + anti-PD-1 ab, but not either agent alone, significantly decreased in vivo disease burden and prolonged overall survival in C1498 engrafted leukemic mice. Combination-treated mice demonstrated increased memory T-cells and mature dendritic cells, lower numbers of regulatory T-cells and evidence of leukemia apoptosis. Furthermore, these effects were associated with markedly increased serum levels of type I interferon (IFN) and IFN gamma. We demonstrate that combining an innate immune agonist with a checkpoint inhibitor synergistically improved anti-tumor activity in a preclinical AML model.
Collapse
Affiliation(s)
- Amanda C. Przespolewski
- Leukemia Service, Departments of Medicine and Immunology, Roswell Park Comprehensive Cancer Center, Buffalo NY, USA
| | - Scott Portwood
- Leukemia Service, Departments of Medicine and Immunology, Roswell Park Comprehensive Cancer Center, Buffalo NY, USA
| | - Eunice S. Wang
- Leukemia Service, Departments of Medicine and Immunology, Roswell Park Comprehensive Cancer Center, Buffalo NY, USA
| |
Collapse
|
3
|
Przespolewski AC, Griffiths EA. BITES and CARS and checkpoints, oh my! Updates regarding immunotherapy for myeloid malignancies from the 2018 annual ASH meeting. Blood Rev 2020; 43:100654. [PMID: 32029263 PMCID: PMC7371541 DOI: 10.1016/j.blre.2020.100654] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 12/30/2019] [Accepted: 01/07/2020] [Indexed: 02/03/2023]
Abstract
It is without question that immune checkpoint inhibitors and adoptive cellular therapies have revolutionized the treatment of solid and hematologic malignancies. Investigators are now developing novel strategies to integrate these groundbreaking modalities into the care of patients with acute myeloid leukemia (AML) and other myeloid malignancies. Here we provide an overview of the most recent developments in immunotherapy for myeloid cancers presented at the 2018 American Society of Hematology annual meeting. Topics discussed include adoptive cellular therapies (CAR-T, NK cell, and vaccines), checkpoint inhibitors, and bispecific T-cell engager (BITE) antibodies. Despite reservations regarding low antigenicity and having long been considered a "cold" tumor, immunotherapy remains a highly promising strategy for patients with aggressive myeloid cancers like myelodysplasia (MDS) and AML.
Collapse
Affiliation(s)
- Amanda C Przespolewski
- Leukemia Section, Department of Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Elizabeth A Griffiths
- Leukemia Section, Department of Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA.
| |
Collapse
|
4
|
Chen GL, Wallace PK, Zhang Y, Tario JD, Przespolewski AC, Becker J, Almyroudis NG, Ross M, Riches M, Segal BH, Brix L, McCarthy PL, Hahn T. Low-Level Cytomegalovirus Antigenemia Promotes Protective Cytomegalovirus Antigen-Specific T Cells after Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:2147-2154. [PMID: 32721522 DOI: 10.1016/j.bbmt.2020.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 12/31/2022]
Abstract
Previous studies have reported a beneficial effect from cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplantation (alloHCT) on immune reconstitution. We determined the CMV antigenemia level associated with increased CMV antigen-specific T cells (CASTs) at day +100 and decreased CMV reactivation after day +100. CMV reactivation and CASTs were measured with CMV antigenemia and CMV-specific major histocompatibility complex multimers. The analysis consisted of 775 CAST measurements obtained before and 30, 100, and 365 days post-alloHCT from 327 consecutive patients treated between 2008 and 2016. Detectable CASTs correlated with recipient (P < .0001) and donor (P < .0001) CMV seropositivity pre-alloHCT. CMV reactivation before day +100 was associated with a higher proportion of patients who achieved ≥3 CASTs/µL by day +100 (61% with versus 39% without reactivation, P < .001). In alloHCT recipients at high risk for CMV reactivation (R+D±) with a maximum of grade II acute graft-versus-host-disease, reactivating CMV before day +100 and achieving ≥3 versus <3 CASTs/µL at day +100 was associated with reduced CMV reactivation from day +100 to +365 (27% versus 62%, P = .04). This protective effect was observed with low-level but not high-level CMV reactivation (<5 versus ≥5/50,000 polymorphonuclear leukocytes + pp65, respectively). These findings suggest low-level CMV reactivation may be beneficial and that treatment may be delayed until progression. These findings will need validation in prospective clinical trials using CMV PCR and antigenemia assays.
Collapse
Affiliation(s)
- George L Chen
- Department of Medicine, Transplant and Cellular Therapy Program, Roswell Park, Buffalo, New York.
| | - Paul K Wallace
- Department of Flow and Image Cytometry, Roswell Park, Buffalo, New York
| | - Yali Zhang
- Department of Medicine, Transplant and Cellular Therapy Program, Roswell Park, Buffalo, New York
| | - Joseph D Tario
- Department of Flow and Image Cytometry, Roswell Park, Buffalo, New York
| | | | - Joanne Becker
- Department of Pathology and Laboratory Medicine, Roswell Park, Buffalo, New York
| | - Nikolaos G Almyroudis
- Department of Internal Medicine, Division of Infectious Diseases, Roswell Park, Buffalo, New York
| | - Maureen Ross
- Department of Medicine, Transplant and Cellular Therapy Program, Roswell Park, Buffalo, New York
| | - Marcie Riches
- Department of Medicine, Bone Marrow Transplant and Cellular Therapy Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brahm H Segal
- Department of Internal Medicine, Division of Infectious Diseases, Roswell Park, Buffalo, New York
| | | | - Philip L McCarthy
- Department of Medicine, Transplant and Cellular Therapy Program, Roswell Park, Buffalo, New York
| | - Theresa Hahn
- Department of Medicine, Transplant and Cellular Therapy Program, Roswell Park, Buffalo, New York
| |
Collapse
|