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Bigley AB, Rezvani K, Shah N, Sekine T, Balneger N, Pistillo M, Agha N, Kunz H, O'Connor DP, Bollard CM, Simpson RJ. Latent cytomegalovirus infection enhances anti-tumour cytotoxicity through accumulation of NKG2C+ NK cells in healthy humans. Clin Exp Immunol 2016; 185:239-51. [PMID: 26940026 PMCID: PMC4955006 DOI: 10.1111/cei.12785] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 02/27/2016] [Accepted: 02/29/2016] [Indexed: 12/22/2022] Open
Abstract
Cytomegalovirus (CMV) infection markedly expands NKG2C+/NKG2A- NK cells, which are potent killers of infected cells expressing human leucocyte antigen (HLA)-E. As HLA-E is also over-expressed in several haematological malignancies and CMV has been linked to a reduced risk of leukaemic relapse, we determined the impact of latent CMV infection on NK cell cytotoxicity against four tumour target cell lines with varying levels of HLA-E expression. NK cell cytotoxicity against K562 (leukaemia origin) and U266 (multiple myeloma origin) target cells was strikingly greater in healthy CMV-seropositive donors than seronegative donors and was associated strongly with target cell HLA-E and NK cell NKG2C expression. NK cell cytotoxicity against HLA-E transfected lymphoma target cells (221.AEH) was ∼threefold higher with CMV, while NK cell cytotoxicity against non-transfected 721.221 cells was identical between the CMV groups. NK cell degranulation (CD107a(+) ) and interferon (IFN)-γ production to 221.AEH cells was localized almost exclusively to the NKG2C subset, and antibody blocking of NKG2C completely eliminated the effect of CMV on NK cell cytotoxicity against 221.AEH cells. Moreover, 221.AEH feeder cells and interleukin (IL)-15 were found to expand NKG2C(+) /NKG2A(-) NK cells preferentially from CMV-seronegative donors and increase NK cell cytotoxicity against HLA-E(+) tumour cell lines. We conclude that latent CMV infection enhances NK cell cytotoxicity through accumulation of NKG2C(+) NK cells, which may be beneficial in preventing the initiation and progression of haematological malignancies characterized by high HLA-E expression.
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Affiliation(s)
- A. B. Bigley
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - K. Rezvani
- Department of Stem Cell Transplantation, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - N. Shah
- Department of Stem Cell Transplantation, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - T. Sekine
- Department of Stem Cell Transplantation, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - N. Balneger
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - M. Pistillo
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - N. Agha
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - H. Kunz
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - D. P. O'Connor
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - C. M. Bollard
- Program for Cell Enhancement and Technologies for Immunotherapy, Sheikh Zayed Institute for Pediatric Surgical Innovation and Center for Cancer and Immunology ResearchChildren's National Health SystemWashingtonDCUSA
| | - R. J. Simpson
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
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2
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Cruz CRY, Lam S, Hanley PJ, Bear AS, Langston C, Cohen AJ, Liu H, Martinez CA, Krance RA, Heslop HE, Rooney CM, Hanson IC, Bollard CM. Robust T cell responses to aspergillosis in chronic granulomatous disease: implications for immunotherapy. Clin Exp Immunol 2013; 174:89-96. [PMID: 23763437 DOI: 10.1111/cei.12156] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2013] [Indexed: 11/30/2022] Open
Abstract
Chronic granulomatous disease (CGD) patients are highly susceptible to invasive aspergillosis and might benefit from aspergillus-specific T cell immunotherapy, which has shown promise in treating those with known T cell defects such as haematopoietic stem cell transplant (HSCT) recipients. But whether such T cell defects contribute to increased risks for aspergillus infection in CGD is unclear. Hence, we set out to characterize the aspergillus-specific T cell response in CGD. In murine CGD models and in patients with CGD we showed that the CD4(+) T cell responses to aspergillus were unimpaired: aspergillus-specific T cell frequencies were even elevated in CGD mice (P < 0·01) and humans (P = 0·02), compared to their healthy counterparts. CD4-depleted murine models suggested that the role of T cells might be redundant because resistance to aspergillus infection was conserved in CD4(+) T cell-depleted mice, similar to wild-type animals. In contrast, mice depleted of neutrophils alone or neutrophils and CD4(+) T cells developed clinical and pathological evidence of pulmonary aspergillosis and increased mortality (P < 0·05 compared to non-depleted animals). Our findings that T cells in CGD have a robust aspergillus CD4(+) T cell response suggest that CD4(+) T cell-based immunotherapy for this disease is unlikely to be beneficial.
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Affiliation(s)
- C R Y Cruz
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, USA
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3
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Weber G, Gerdemann U, Caruana I, Savoldo B, Hensel NF, Rabin KR, Shpall EJ, Melenhorst JJ, Leen AM, Barrett AJ, Bollard CM. Generation of multi-leukemia antigen-specific T cells to enhance the graft-versus-leukemia effect after allogeneic stem cell transplant. Leukemia 2013; 27:1538-47. [PMID: 23528871 DOI: 10.1038/leu.2013.66] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/07/2013] [Accepted: 02/20/2013] [Indexed: 12/16/2022]
Abstract
Adoptive immunotherapy with ex vivo expanded T cells is a promising approach to prevent or treat leukemia. Myeloid leukemias express tumor-associated antigens (TAA) that induce antigen-specific cytotoxic T lymphocyte (CTL) responses in healthy individuals. We explored the feasibility of generating TAA-specific CTLs from stem cell donors of patients with myeloid leukemia to enhance the graft-versus-leukemia effect after stem cell transplantation. CTL lines were manufactured from peripheral blood of 10 healthy donors by stimulation with 15mer peptide libraries of five TAA (proteinase 3 (Pr3), preferentially expressed antigen in melanoma, Wilms tumor gene 1 (WT1), human neutrophil elastase (NE) and melanoma-associated antigen A3) known to be expressed in myeloid leukemias. All CTL lines responded to the mix of five TAA and were multi-specific as assessed by interferon-γ enzyme-linked immunospot. Although donors showed individual patterns of antigen recognition, all responded comparably to the TAAmix. Immunogenic peptides of WT1, Pr3 or NE could be identified by epitope mapping in all donor CTL lines. In vitro experiments showed recognition of partially human leukocyte antigen (HLA)-matched myeloid leukemia blasts. These findings support the development of a single clinical grade multi-tumor antigen-specific T-cell product from the stem cell source, capable of broad reactivity against myeloid malignancies for use in donor-recipient pairs without limitation to a certain HLA-type.
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Affiliation(s)
- G Weber
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital and Texas Children's Hospital, Houston, TX 77030, USA
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4
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Rathore N, Eissa HM, Margolin JF, Liu H, Wu MF, Horton T, Kamdar K, Dreyer Z, Steuber P, Rabin KR, Redell M, Allen CE, McClain KL, Guillerman RP, Bollard CM. Pediatric Hodgkin lymphoma: are we over-scanning our patients? Pediatr Hematol Oncol 2012; 29:415-23. [PMID: 22632168 PMCID: PMC3685486 DOI: 10.3109/08880018.2012.684198] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite the favorable outcome of most pediatric patients with Hodgkin lymphoma (HL), there is rising concern about risks of carcinogenesis from both diagnostic and therapeutic radiation exposure for patients treated on study protocols. Although previous studies have investigated radiation exposure during treatment, radiation from post-treatment surveillance imaging may also increase the likelihood of secondary malignancies. All diagnostic imaging examinations involving ionizing radiation exposure performed for surveillance following completion of therapy were recorded for 99 consecutive pediatric patients diagnosed with HL from 2000 to 2010. Cumulative radiation dosage from these examinations and the frequency of relapse detection by these examinations were recorded. In the first 2 years following completion of therapy, patients in remission received a median of 11 examinations (range 0-26). Only 13 of 99 patients relapsed, 11 within 5 months of treatment completion. No relapse was detected by 1- or 2-view chest radiographs (n = 38 and 296, respectively), abdomen/pelvis computed tomography (CT) scans (n = 211), or positron emission tomography (PET) scans alone (n = 11). However, 10/391 (2.6%) of chest CT scans, 4/364 (1.1%) of neck CT scans, and 3/47 (6.4%) of PET/CT scans detected relapsed disease. Thus, only 17 scans (1.3%) detected relapse in a total of 1358 scans. Mean radiation dosages were 31.97 mSv for Stage 1, 37.76 mSv for Stage 2, 48.08 mSv for Stage 3, and 51.35 mSv for Stage 4 HL. Approximately 1% of surveillance imaging examinations identified relapsed disease. Given the very low rate of relapse detection by surveillance imaging stipulated by current protocols for pediatric HL patients, the financial burden of the tests themselves, the high cure rate, and risks of second malignancy from ionizing radiation exposure, modification of the surveillance strategy is recommended.
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Affiliation(s)
- N. Rathore
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - H. M. Eissa
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - J. F. Margolin
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - H. Liu
- Division of Biostatistics, Dan L. Duncan Cancer Center, Department of Medicine, Section of Hematology/Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - M. F. Wu
- Division of Biostatistics, Dan L. Duncan Cancer Center, Department of Medicine, Section of Hematology/Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - T. Horton
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - K. Kamdar
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Z. Dreyer
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - P. Steuber
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - K. R. Rabin
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - M. Redell
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - C. E. Allen
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - K. L. McClain
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA,Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - R. P. Guillerman
- Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - C. M. Bollard
- Texas Children’s Cancer Center and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
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Hickey MJ, Malone CK, Erickson KL, Gerschenson LE, Lin AH, Inagaki A, Hiraoka K, Kasahara N, Mueller B, Kruse CA, Kong S, Tyler B, Zhou J, Carter BS, Brem H, Junghans RP, Sampath P, Lai RK, Recht LD, Reardon DA, Paleologos N, Groves M, Rosenfeld MR, Davis T, Green J, Heimberger A, Sampson J, Hashimoto N, Tsuboi A, Chiba Y, Kijima N, Oka Y, Kinoshita M, Kagawa N, Fujimoto Y, Sugiyama H, Yoshimine T, Birks SM, Burnet M, Pilkington GJ, Yu JS, Wheeler CJ, Rudnick J, Mazer M, Wang HQ, Nuno MA, Richardson JE, Fan X, Ji J, Chu RM, Bender JG, Hawkins EW, Black KL, Phuphanich S, Pollack IF, Jakacki RI, Butterfield LH, Okada H, Hunt MA, Pluhar GE, Andersen BM, Gallardo JL, Seiler CO, SantaCruz KS, Ohlfest JR, Bauer DF, Lamb LS, Harmon DK, Zheng X, Romeo AK, Gillespie GY, Parker JN, Markert JM, Jacobs VL, Landry RP, De Leo JA, Bromberg JE, Doorduijn J, Baars JW, van Imhoff GW, Enting R, van den Bent MJ, Murphy KA, Bedi J, Epstein A, Ohlfest JR, Olin M, Andersen B, Swier L, Ohlfest J, Litterman AJ, Zellmer DM, Ohlfest JR, Chiocca EA, Aguilar LK, Aguilar-Cordova E, Manzanera AG, Harney KR, Portnow J, Badie B, Lesniak M, Bell S, Ray-Chaudhuri A, Kaur B, Hardcastle J, Cavaliere R, McGregor J, Lo S, Chakarvarti A, Grecula J, Newton H, Trask TW, Baskin DS, New PZ, Zeng J, See AP, Phallen J, Belcaid Z, Durham N, Meyer C, Albesiano E, Pradilla G, Ford E, Hammers H, Tyler B, Brem H, Tran PT, Pardoll D, Drake CG, Lim M, Ghazi A, Ashoori A, Hanley P, Salsman V, Schaffer DR, Grada Z, Kew Y, Powell SZ, Grossman R, Scheurer ME, Leen AM, Rooney CM, Bollard CM, Heslop HE, Gottschalk S, Ahmed N, Hu J, Patil C, Nuno M, Wheeler C, Rudnick J, Phuphanich S, Mazer M, Wang HQ, Chu R, Black K, Yu J, Marabelle A, Kohrt H, Brody J, Luong R, Tse V, Levy R, Li YM, Jun H, Shahryar M, Daniel VA, Walter HA, Thaipisuttikul I, Avila E, Mitchell DA, Archer GE, Friedman HS, Herndon JE, Bigner DD, Sampson JH, Johnson LA, Archer GE, Nair SK, Schmittling R, Reap E, Sampson JH, Mitchell DA, Li YM, Shahryar M, Jun H, Daniel VA, Walter HA, Knisely JP, Kluger H, Flanigan J, Sznol M, Yu JB, Chiang VL, Prins RM, Kim W, Soto H, Lisiero DN, Lisiero DN, Liau LM. IMMUNOTHERAPY. Neuro Oncol 2011; 13:iii34-iii40. [PMCID: PMC3199174 DOI: 10.1093/neuonc/nor151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
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6
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Ramos CA, Savoldo B, Liu E, Bollard CM, Mims MP, Keating MJ, Gee AP, Mei Z, Rooney CM, Heslop HE, Brenner MK, Dotti G. Effect of a costimulatory endodomain on the performance of T cells expressing CD19-directed chimeric antigen receptors (CARs) in subjects with relapsed/refractory B-cell malignancies. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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7
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Schuster SJ, Hosing C, Shpall EJ, Levine B, Aqui N, Chong EA, Svoboda J, Gordon A, McMannis JD, Bosque D, Cotte J, Brennan A, Zheng Z, Leinbach L, Xu Y, Veloso EA, Decker W, Bollard CM, Keating MJ, June CH. Adoptive immunotherapy with autologous CD3/CD28-costimulated T cells after fludarabine-based chemotherapy in patients with chronic lymphocytic leukemia. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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8
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Fujita M, Kohanbash G, McDonald HA, Delamarre L, Decker SA, Ohlfest JR, Okada H, Okada H, Kalinski P, Ueda R, Hoji A, Kohanbash G, Donegan TE, Mintz AH, Engh JA, Bartlett DL, Brown CK, Zeh H, Holtzman MP, Reinhart TA, Whiteside TL, Butterfield LH, Hamilton RL, Potter DM, Pollack IF, Salazar AM, Lieberman FS, Olin MR, Andersen BM, Grogan PT, Hunt M, Popescu FE, Xiong ZL, Seiler C, Forster CL, SantaCruz KS, Chen W, Blazar BR, Ohlfest JR, Hu J, Wheeler CJ, Phuphanich S, Rudnick J, Nuno M, Serrano N, Dantis J, Richardson J, Mazer M, Wang HQ, Chu R, Black KL, Yu J, Li YM, Vallera DA, Hall WA, Rudnick JD, Wheeler CJ, Phuphanich S, Chu RM, Mazer M, Wang H, Serrano N, Nuno M, Richardson J, Hu J, Black KL, Yu JS, Yang I, Han S, Tihan T, Wrensch M, Parsa AT, Li YM, Vallera DA, Hall WA, Andersen BM, Hunt MA, Gallardo JL, Seiler C, Pluhar GE, Ohlfest JR, Brown CE, Starr R, Martinez C, Bading J, Ressler JA, Badie B, Jensen MC, Glick RP, Ksendzovsky A, Zengou R, Polak P, Simonini V, Lichtor T, Feinstein D, Chow KK, Ahmed N, Salsman VS, Kew Y, Powell S, Grossman R, Heslop HE, Gottschalk S, Barnett FH, Marchetti V, Wang M, Johnson A, Scheppke L, Jacobson R, Nemerow G, Friedlander M, Ahmed N, Salsman V, Kew Y, Leen AM, Bollard CM, Powell S, Grossman R, Rooney C, Heslop HE, Gottschalk S, New PZ, Bollard CM, Salvoldo B, Heslop H. Immunotherapy. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Shafer JA, Heslop HE, Brenner MK, Carrum G, Wu MF, Liu H, Ahmed N, Gottschalk S, Kamble R, Leung KS, Myers GD, Bollard CM, Krance RA. Outcome of hematopoietic stem cell transplant as salvage therapy for Hodgkin's lymphoma in adolescents and young adults at a single institution. Leuk Lymphoma 2010; 51:664-70. [PMID: 20367182 DOI: 10.3109/10428190903580410] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
For patients with relapsed Hodgkin's lymphoma (HL), high dose chemotherapy with stem cell rescue (HDCT-SCT) may improve survival over chemotherapy alone. We assessed the outcomes of HDCT-SCT in 37 consecutive adolescent and young adult patients with relapsed HL whose malignancy was categorized based on sensitivity to chemotherapy. We determined whether current outcomes supported the use of HDCT-SCT in all of our patients or just those patients with lower-risk characteristics such as chemosensitivity. With a median follow-up of 6.5 years, the 2-year overall survival (OS) was 89% (95% CI: 62-97%) for the chemosensitive patients (n = 21), whereas for patients with resistant disease (n = 16), OS was 53% (95% CI: 25-74%). Both autologous and allogeneic transplants were well tolerated, with 100-day treatment-related mortality under 10%. Our data show encouraging outcomes for patients with chemosensitive relapsed HL who receive hematopoietic stem cell transplant (HSCT) and support the value of the procedure even when the disease is chemoresistant.
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Affiliation(s)
- J A Shafer
- Center for Cell and Gene Therapy, Houston, TX 77030, USA
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10
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New PZ, Bollard CM. Targeted immunotherapy for Epstein-Barr virus: Positive central nervous system lymphoma in immunosuppressed patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e12529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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Abstract
T cell therapies are increasingly used for the treatment of malignancies and viral-associated diseases. Initial studies focused on the use of unmanipulated T cell populations after allogeneic stem cell transplantation. More recently, the use of antigen-specific T cells has been explored. This chapter reviews the clinical experience with polyclonal Epstein-Barr virus (EBV)-specific cytotoxic T cells (CTL) for the treatment of EBV-associated malignancies. Strategies on how to improve the antitumor activity of EBV-specific CTL are being discussed. If effective, these strategies will have broad implications for T cell therapies for a range of human tumors with defined antigens.
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Affiliation(s)
- S Gottschalk
- Center for Gene and Cell Therapy, Baylor College of Medicine, 6621 Fannin Street MC 3-3320, 77030 Houston, USA.
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12
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Kennedy-Nasser AA, Bollard CM. T cell therapies following hematopoietic stem cell transplantation: surely there must be a better way than DLI? Bone Marrow Transplant 2007; 40:93-104. [PMID: 17502898 DOI: 10.1038/sj.bmt.1705667] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Advances in the past few years have significantly improved adoptive immunotherapy strategies available following autologous and allogeneic hematopoietic stem cell transplantation (HSCT). Minimal residual disease, relapsed disease and viral infections remain a significant cause of mortality in patients undergoing HSCT. Novel therapies are critically needed to overcome these management dilemmas, while sparing the graft-versus-tumor effect and avoiding graft-versus-host disease. This review focuses on the T-cell strategies currently available to allay disease while minimizing toxicities in patients who have undergone HSCT.
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Affiliation(s)
- A A Kennedy-Nasser
- Center for Cell and Gene Therapy, Baylor College of Medicine, 6621 Fannin Street, Houston, TX 77030, USA
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Myers GD, Bollard CM, Wu MF, Weiss H, Rooney CM, Heslop HE, Leen AM. Reconstitution of adenovirus-specific cell-mediated immunity in pediatric patients after hematopoietic stem cell transplantation. Bone Marrow Transplant 2007; 39:677-86. [PMID: 17417664 DOI: 10.1038/sj.bmt.1705645] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Adenovirus (adv) is a significant cause of morbidity and mortality in pediatric hematopoietic stem cell transplant recipients, and control of infection seems to require antigen-specific T cells. We evaluated the recovery of adv-specific cellular immunity in this patient population related to degree of T-cell immunosuppressive therapy and compared this to adv cellular immunity of normal donors. Over 12 months, we monitored for adv DNA in stool and blood of patients and in the blood of a normal donor group. Twenty-two pediatric hematopoietic stem cell transplant (HSCT) patients (14 months-20 years) who received matched-related (MRD n=6), mismatched related (Haplo n=6) or matched unrelated donor (MUD n=10) grafts, were followed and results compared to healthy controls (n=8). Adv was detected by polymerase chain reaction in blood and/or stool from 81.8% of patients on at least one occasion post-HSCT, but only 68% of patients developed symptomatic adv infections. Recovery of adv-specific T cells was significantly delayed in the MUD and Haplo recipients, whereas recovery in the MRD group was similar to levels detected in healthy donors within 30 days post-transplant. In conclusion, recipients of alternative donor transplants at our institution have significantly delayed adv-specific cellular immune recovery, which correlates to an increased risk of adv-associated morbidity and mortality.
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Affiliation(s)
- G D Myers
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, TX 77030, USA
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14
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Lamba R, Carrum G, Myers GD, Bollard CM, Krance RA, Heslop HE, Brenner MK, Popat U. Cytomegalovirus (CMV) infections and CMV-specific cellular immune reconstitution following reduced intensity conditioning allogeneic stem cell transplantation with Alemtuzumab. Bone Marrow Transplant 2006; 36:797-802. [PMID: 16151431 DOI: 10.1038/sj.bmt.1705121] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We studied the incidence and recurrence of Cytomegalovirus (CMV) infection and reactivation in 38 recipients of Alemtuzumab reduced intensity conditioning-stem cell transplantation, and used CMV-HLA tetramer studies to discover if these events correlated with recovery of circulating CMV-specific CD8+ T cells (cytotoxic T lymphocyte (CTLs)). The cumulative incidence of CMV infection was 60% at 1 year (95% CI, 45-78%) with a median reactivation time of 24 days (range 5-95 days). All patients with CMV reactivation received Ganciclovir or Foscarnet, and only one developed CMV disease. More strikingly, only 8/21 patients had relapse of CMV antigenemia. Tetramer analysis in 13 patients showed that 11 reconstituted CMV CTLs (7/11 by day 30 and 10/11 by day 90). The development of CMV infection was accompanied by a >5-fold rise of CMV CTLs. Recurrence of CMV infection occurred only in the patients who failed to generate a CTL response to the virus. Hence, recipients of SCT using Alemtuzumab-RIC are initially profoundly immunosuppressed and have a high incidence of early CMV reactivation. However, in the majority of patients, infection is transient, and antiviral T cell reconstitution is rapid. Monitoring with CMV-specific CTLs may help identify the subset of patients at risk from recurrent infection or disease.
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Affiliation(s)
- R Lamba
- Department of Medicine, Baylor College of Medicine and The Methodist Hospital, Houston, TX 77030, USA.
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Leen AM, Myers GD, Bollard CM, Huls MH, Sili U, Gee AP, Heslop HE, Rooney CM. T-Cell Immunotherapy for Adenoviral Infections of Stem-Cell Transplant Recipients. Ann N Y Acad Sci 2005; 1062:104-15. [PMID: 16461793 DOI: 10.1196/annals.1358.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Human adenoviruses are ubiquitous lytic DNA viruses that can be divided into 51 different serotypes, grouped from A to F on the basis of genome size, composition, homology, and organization. Adenovirus infections, although frequent, are rarely fatal in immunocompetent individuals, due to potent innate and adaptive immune responses. By contrast, adenoviruses are a significant cause of morbidity and mortality in immunosuppressed individuals, for whom there are limited treatment options. Since antiviral drugs have variable efficacy in the treatment of severe adenovirus disease, iatrogenic reconstitution with in vitro expanded virus-specific cytotoxic T lymphocytes (CTLs) is an attractive option for prophylaxis and treatment, particularly because the endogenous recovery of adenovirus-specific T cells has proved important in controlling infection in vivo. Thus, we have characterized human T-cell responses to adenovirus in vitro and explored the potential of adoptive T-cell immunotherapy as a prophylactic or therapeutic strategy for adenovirus infections posttransplant.
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Affiliation(s)
- A M Leen
- Center for Cell and Gene Therapy, Department of Pediatrics-Hem/Onc, Baylor College of Medicine, 6621 Fannin St., MC3-3320 Houston, TX 77030, USA
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16
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Myers GD, Krance RA, Weiss H, Kuehnle I, Demmler G, Heslop HE, Bollard CM. Adenovirus infection rates in pediatric recipients of alternate donor allogeneic bone marrow transplants receiving either antithymocyte globulin (ATG) or alemtuzumab (Campath). Bone Marrow Transplant 2005; 36:1001-8. [PMID: 16184180 DOI: 10.1038/sj.bmt.1705164] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Infectious complications due to adenovirus are of increasing concern after allogeneic stem cell transplantation. Over the past 4 years, we have modified our conditioning regimens to use alemtuzumab in preference to anti-thymocyte globulin (ATG) for pediatric patients receiving stem cell transplants from alternate donors. Recent reports in adult studies implicate alemtuzumab as a risk factor for adenovirus infection. We therefore evaluated the incidence of adenovirus infection in pediatric patients receiving either ATG or alemtuzumab in their conditioning regimens. Of the 111 patients evaluated, a total of 54 patients received ATG and 57 patients received alemtuzumab. In total, 35/111 (32%) patients were infected by adenovirus, and 9/111 (8%) had adenovirus disease (AD). Adenovirus infection was greater in the alemtuzumab group than the ATG group (23/57 vs 12/54) (P=0.039) and disseminated AD was more frequent in the alemtuzumab group vs the ATG group (8/57 and 1/54 respectively) (P=0.032). The presence of Grade 3-4 graft-versus-host disease was a risk factor for adenovirus infection. Our findings highlight the fact that adenovirus infection is a frequent complication after stem cell transplantation from alternate donors in the pediatric population and that alemtuzumab increases the risk of infection compared to ATG. This work will help in identifying at-risk populations for our upcoming immunotherapy trial using adoptively transferred donor-derived adenovirus-specific cytotoxic T lymphocytes.
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MESH Headings
- Adenovirus Infections, Human/chemically induced
- Adenovirus Infections, Human/etiology
- Adolescent
- Alemtuzumab
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/toxicity
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/administration & dosage
- Antibodies, Neoplasm/toxicity
- Antilymphocyte Serum/administration & dosage
- Bone Marrow Transplantation/adverse effects
- Bone Marrow Transplantation/methods
- Child
- Child, Preschool
- Graft vs Host Disease/complications
- Hematologic Diseases/complications
- Hematologic Diseases/therapy
- Humans
- Incidence
- Infant
- Retrospective Studies
- Risk Factors
- Tissue Donors
- Transplantation Conditioning/adverse effects
- Transplantation Conditioning/methods
- Transplantation, Homologous
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Affiliation(s)
- G D Myers
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, 77030, USA
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Lamba R, Myers DG, Popat U, Bollard CM, Carrum G, Krance R, Heslop HE, Brenner MK. Assessing cytomegalovirus (CMV) specific immune recovery after reduced intensity conditioning allogeneic stem cell transplantation with monoclonal antibody (Alemtuzumab). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6650] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Lamba
- Baylor Coll of Medicine, Houston, TX
| | | | - U. Popat
- Baylor Coll of Medicine, Houston, TX
| | | | - G. Carrum
- Baylor Coll of Medicine, Houston, TX
| | - R. Krance
- Baylor Coll of Medicine, Houston, TX
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Affiliation(s)
- H E Heslop
- Center for Gene and Cell Therapy, Baylor College of Medicine, The Methodist Hospital and Texas Children's Hospital, Houston, Texas 77030, USA.
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Heslop HE, Bollard CM, Gottschalk S, Kuehnle I, Huls MH, Gee AP, Brenner MK, Rooney CM. Immune therapy for EBV infections after hemopoietic stem-cell transplant. Cytotherapy 2003; 4:433-4. [PMID: 12473214 DOI: 10.1080/146532402320776071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H E Heslop
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston TX 77030, USA
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Rossig C, Bollard CM, Nuchtern JG, Merchant DA, Brenner MK. Targeting of G(D2)-positive tumor cells by human T lymphocytes engineered to express chimeric T-cell receptor genes. Int J Cancer 2001; 94:228-36. [PMID: 11668503 DOI: 10.1002/ijc.1457] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Genetic engineering of human T lymphocytes to express tumor antigen-specific chimeric immune receptors is an attractive means for providing large numbers of effector cells for adoptive immunotherapy while bypassing major mechanisms of tumor escape from immune recognition. We have applied this strategy to the targeting of a G(D2)-positive tumor, neuroblastoma, which is the commonest extracranial solid tumor of childhood. Chimeric immune receptors were generated by joining an extracellular antigen-binding domain derived from either of the 2 ganglioside G(D2)-specific antibodies sc7A4 and sc14.G2a to a cytoplasmic signaling domain. The variable domains of hybridoma antibody 14.G2a were cloned and selected using a phage display approach. Upon coincubation with G(D2)-expressing tumor cell targets, human T lymphocytes transduced with recombinant retroviruses encoding chimeric receptors based on sc14.G2a, but not sc7A4, secreted significant levels of cytokines in a pattern comparable to the cytokine response obtained by engagement of the CD3 receptor. T cells transduced with the sc14.G2a-based chimeric T-cell receptors also displayed specific lysis of G(D2)-positive neuroblastoma cells, which was blocked in the presence of monoclonal antibody 14.G2a. In the absence of nonspecific stimulation of transduced cells, their functionality declined over time and antigenic stimulation of the chimeric receptor alone did not induce commitment to proliferation. These results support the feasibility of redirecting human T lymphocytes to a tumor-associated ganglioside epitope but emphasize that successful chimeric receptor-mediated adoptive immunotherapy will require additional strategies that overcome functional inactivation of gene-modified primary T lymphocytes.
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Affiliation(s)
- C Rossig
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA
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Abstract
Improvements in the chemotherapeutic and transplant regimens have had a significant impact in improving survival rates for paediatric leukaemia. However, there are still important problems to address including what options are available for patients with chemoresistant disease and what strategies are available to avoid the concerns regarding the toxicity associated with highly cytotoxic treatment regimens. Gene therapy and immunotherapy protocols hold great promise. Using gene transfer of a marker gene, a number of biological issues in the therapy of leukaemia have been addressed. For example, by gene marking autologous bone marrow grafts it has been possible to demonstrate that infused marrow contributes to relapse in acute and chronic myeloid leukaemias. In the allogeneic transplant setting, genetically modified T-cells have proven valuable for the prophylaxis and treatment of viral diseases and may have an important role in preventing or treating disease relapse. Gene transfer is also being used to modify tumour function, enhance immunogenicity, and confer drug-resistance to normal haematopoietic stem cells. With the continued scientific advancements in this field, gene therapy will almost certainly have a major impact on the treatment of paediatric leukaemia in the future.
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Affiliation(s)
- R F Rousseau
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USA
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Abstract
Gene-marking studies were the first approved clinical protocols introducing exogenous genetic material into human cells. Such studies were never intended to provide direct therapeutic benefit. Instead, they were expected to provide information about normal cell biology and disease pathogenesis that could not be obtained in any other way. However, the information gained from such studies has had a significant impact on disease management. Gene-marking studies have provided valuable insights into the biology of the human stem cell, factors that influence the efficiency of gene transfer, mechanisms of relapse after stem cell transplantation, and the pharmacodynamics of adoptive cellular immunotherapy. With continuing advances in gene-marking technology, the value of the information provided by these studies increases, thereby ensuring their continued relevance to the field of gene transfer.
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Affiliation(s)
- C M Bollard
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas 77030, USA.
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Abstract
The experience with central venous implantable devices (portacaths) has been reviewed in children attending the Auckland Hospital Haemophilia Centre. Fourteen children had 23 portacaths inserted. Thirteen had severe Haemophilia A, of whom five had high responding inhibitors to factor VIII. All the children were HIV negative. Ages ranged from 4 months to 13 years at the time of initial placement and 12 were under 5 years. Indications for portacath placement included primary and secondary prophylaxis, induction of immune tolerance, prophylactic therapy post intracranial haemorrhage and poor venous access. Catheter-related infections occurred in 48% of cases. Staphylococcal species were the most common organisms isolated followed by gram-negative bacilli. 63% of the infections were successfully cleared with antibiotics. Haematoma formation occurred in 17% of catheters, primarily in patients who had high factor VIII inhibitor levels. Mechanical problems including blockage, leakage and extrusion of the portacath occurred less frequently (13%). The significant rate of infection in this immunocompetent population is consistent with other reports. Despite the obvious benefits of portacaths this complication is potentially serious and causes appreciable morbidity. In contrast, bleeding complication rates were relatively low.
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Affiliation(s)
- C M Bollard
- The Auckland Haemophilia Centre, Auckland Hospital, Auckland, New Zealand
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