1
|
Ramirez GA, Tassi E, Noviello M, Mazzi BA, Moroni L, Citterio L, Zagato L, Tombetti E, Doglio M, Baldissera EM, Bozzolo EP, Bonini C, Dagna L, Manfredi AA. Histone-Specific CD4 + T Cell Plasticity in Active and Quiescent Systemic Lupus Erythematosus. Arthritis Rheumatol 2024; 76:739-750. [PMID: 38111123 DOI: 10.1002/art.42778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 03/23/2023] [Revised: 10/31/2023] [Accepted: 12/11/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE The aim of this study was to assess whether circulating histone-specific T cells represent tools for precision medicine in systemic lupus erythematosus (SLE). METHODS Seroprevalence of autoantibodies and HLA-DR beta (DRB) 1 profile were assessed among 185 patients with SLE and combined with bioinformatics and literature evidence to identify HLA-peptide autoepitope couples for ex vivo detection of antigen-specific T cells through flow cytometry. T cell differentiation and polarization was investigated in patients with SLE, patients with Takayasu arteritis, and healthy controls carrying HLA-DRB1*03:01 and/or HLA-DRB1*11:01. SLE Disease Activity Index 2000 and Lupus Low Disease Activity State were used to estimate disease activity and remission. RESULTS Histone-specific CD4+ T cells were selectively detected in patients with SLE. Among patients with a history of anti-DNA antibodies, 77% had detectable histone-specific T cells, whereas 50% had lymphocytes releasing cytokines or upregulating activation markers after in vitro challenge with histone peptide antigens. Histone-specific regulatory and effector T helper (Th) 1-, Th2-, and atypical Th1/Th17 (Th1*)-polarized cells were significantly more abundant in patients with SLE with quiescent disease. In contrast, total Th1-, Th2-, and Th1*-polarized and regulatory T cells were similarly represented between patients and controls or patients with SLE with active versus quiescent disease. Histone-specific effector memory T cells accumulated in the blood of patients with quiescent SLE, whereas total effector memory T cell counts did not change. Immunosuppressants were associated with expanded CD4+ histone-specific naive T (TN) and terminally differentiated T cells. CONCLUSION Histone-specific T cells are selectively detected in patients with SLE, and their concentration in the blood varies with disease activity, suggesting that they represent innovative tools for patient stratification and therapy.
Collapse
Affiliation(s)
- Giuseppe A Ramirez
- Università Vita-Salute San Raffaele, Milan, and IRCCS Ospedale San Raffaele, Milan, Italy
| | | | | | | | - Luca Moroni
- Università Vita-Salute San Raffaele, Milan, and IRCCS Ospedale San Raffaele, Milan, Italy
| | | | | | | | | | | | | | - Chiara Bonini
- Università Vita-Salute San Raffaele, Milan, and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Lorenzo Dagna
- Università Vita-Salute San Raffaele, Milan, and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Angelo A Manfredi
- Università Vita-Salute San Raffaele, Milan, and IRCCS Ospedale San Raffaele, Milan, Italy
| |
Collapse
|
2
|
Manfredi F, Stasi L, Buonanno S, Marzuttini F, Noviello M, Mastaglio S, Abbati D, Potenza A, Balestrieri C, Cianciotti BC, Tassi E, Feola S, Toffalori C, Punta M, Magnani Z, Camisa B, Tiziano E, Lupo-Stanghellini MT, Branca RM, Lehtiö J, Sikanen TM, Haapala MJ, Cerullo V, Casucci M, Vago L, Ciceri F, Bonini C, Ruggiero E. Harnessing T cell exhaustion and trogocytosis to isolate patient-derived tumor-specific TCR. Sci Adv 2023; 9:eadg8014. [PMID: 38039364 PMCID: PMC10691777 DOI: 10.1126/sciadv.adg8014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 11/02/2023] [Indexed: 12/03/2023]
Abstract
To study and then harness the tumor-specific T cell dynamics after allogeneic hematopoietic stem cell transplant, we typed the frequency, phenotype, and function of lymphocytes directed against tumor-associated antigens (TAAs) in 39 consecutive transplanted patients, for 1 year after transplant. We showed that TAA-specific T cells circulated in 90% of patients but display a limited effector function associated to an exhaustion phenotype, particularly in the subgroup of patients deemed to relapse, where exhausted stem cell memory T cells accumulated. Accordingly, cancer-specific cytolytic functions were relevant only when the TAA-specific T cell receptors (TCRs) were transferred into healthy, genome-edited T cells. We then exploited trogocytosis and ligandome-on-chip technology to unveil the specificities of tumor-specific TCRs retrieved from the exhausted T cell pool. Overall, we showed that harnessing circulating TAA-specific and exhausted T cells allow to isolate TCRs against TAAs and previously not described acute myeloid leukemia antigens, potentially relevant for T cell-based cancer immunotherapy.
Collapse
Affiliation(s)
- Francesco Manfredi
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Lorena Stasi
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Silvia Buonanno
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Francesca Marzuttini
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Maddalena Noviello
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Sara Mastaglio
- IRCCS San Raffaele Scientific Institute, Hematology and Hematopoietic Stem Cell Transplantation Unit, via Olgettina 60, Milan 20132, Italy
| | - Danilo Abbati
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Alessia Potenza
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Chiara Balestrieri
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
- Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, via Olgettina 60, Milan 20132, Italy
| | - Beatrice Claudia Cianciotti
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Elena Tassi
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Sara Feola
- University of Helsinki, ImmunoVirotherapy Lab, Yliopistonkatu 4, 00100 Helsinki, Finland
| | - Cristina Toffalori
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation and Infectious Disease, Unit of Immunogenetics, Leukemia Genomics and Immunobiology, via Olgettina 60, Milan 20132, Italy
| | - Marco Punta
- Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, via Olgettina 60, Milan 20132, Italy
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation and Infectious Disease, Unit of Immunogenetics, Leukemia Genomics and Immunobiology, via Olgettina 60, Milan 20132, Italy
| | - Zulma Magnani
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Barbara Camisa
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Elena Tiziano
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| | - Maria Teresa Lupo-Stanghellini
- IRCCS San Raffaele Scientific Institute, Hematology and Hematopoietic Stem Cell Transplantation Unit, via Olgettina 60, Milan 20132, Italy
| | - Rui Mamede Branca
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, 171 65 Solna, Sweden
| | - Janne Lehtiö
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, 171 65 Solna, Sweden
| | - Tiina M. Sikanen
- Drug Research Program, Faculty of Pharmacy, Division of Pharmaceutical Chemistry and Technology, Helsinki University,, Viikinkaari 5E, 00014 Helsinki, Finland
| | - Markus J. Haapala
- Drug Research Program, Faculty of Pharmacy, Division of Pharmaceutical Chemistry and Technology, Helsinki University,, Viikinkaari 5E, 00014 Helsinki, Finland
| | - Vincenzo Cerullo
- University of Helsinki, ImmunoVirotherapy Lab, Yliopistonkatu 4, 00100 Helsinki, Finland
| | - Monica Casucci
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation and Infectious Disease, Innovative Immunotherapies Unit, via Olgettina 60, Milan 20132, Italy
| | - Luca Vago
- IRCCS San Raffaele Scientific Institute, Hematology and Hematopoietic Stem Cell Transplantation Unit, via Olgettina 60, Milan 20132, Italy
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation and Infectious Disease, Unit of Immunogenetics, Leukemia Genomics and Immunobiology, via Olgettina 60, Milan 20132, Italy
- Vita Salute San Raffaele University, Milan, Italy
| | - Fabio Ciceri
- IRCCS San Raffaele Scientific Institute, Hematology and Hematopoietic Stem Cell Transplantation Unit, via Olgettina 60, Milan 20132, Italy
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation and Infectious Disease, Innovative Immunotherapies Unit, via Olgettina 60, Milan 20132, Italy
| | - Chiara Bonini
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation and Infectious Disease, Innovative Immunotherapies Unit, via Olgettina 60, Milan 20132, Italy
| | - Eliana Ruggiero
- IRCCS San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Experimental Hematology Unit, via Olgettina 60, Milan 20132, Italy
| |
Collapse
|
3
|
Orofino G, Xue E, Doglio M, Noviello M, Tassi E, Cristante M, Acerbis A, Clerici D, Farina F, Campodonico E, Bruno A, Piemontese S, Mastaglio S, Diral E, Milani R, Ruggeri A, Corti C, Vago L, Bonini C, Peccatori J, Ciceri F, Lupo Stanghellini MT, Greco R. Dynamics of polyclonal immuno-reconstitution after allogeneic transplant with post-transplant cyclophosphamide and letermovir. Bone Marrow Transplant 2023; 58:1104-1111. [PMID: 37468541 DOI: 10.1038/s41409-023-02046-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/28/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
Cytomegalovirus (CMV) reactivations are strong stimulators of immune-reconstitution (IR) in hematopoietic stem cell transplantation (HSCT) recipients. Herein, we analyzed 317 CMV-seropositive consecutive patients (n = 109 letermovir, LTV; n = 208 no-LTV), undergoing HSCT with post-transplant cyclophosphamide (PTCy) and calcineurin inhibitor- (CNI) free graft-versus-host-disease (GvHD) prophylaxis. At day+90, median CD19+/mm3 was higher in LTV-cohort: 5.5 [0;439] versus 2 [0;294], p = 0.008; median CD3+/mm3 counts were lower in LTV-cohort, with no differences in CD4+, CD8+ and NK-cells. At day+180 median CD3+, CD4+ and CD8+/mm3 values were comparable between groups. Higher CD19+/mm3 counts were observed in LTV-cohort: 62 [0; 2983] versus 42 [0; 863]. Significantly higher median NK/mm3 values were seen in LTV-cohort: 225.5 [0;763] versus 163.5 [0;1181], p = 0.0003. The impact of LTV on B-cell IR at 3 months and NK-cell levels at 6 months was retained in multivariate analysis (p < 0.01), whereas the effect on T-cells was not confirmed. Moreover, we confirmed a significant reduction of clinically-relevant CMV, and moderate-to- severe chronic GvHD in LTV-cohort. Overall, in our study the use of LTV was associated with a slight improvement of B-cell and NK-cells reconstitution, with only minor impact on T-cell subsets, giving new insights on polyclonal IR for HSCT recipients in the LTV era.
Collapse
Affiliation(s)
- Giorgio Orofino
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Università Vita-Salute San Raffaele, Milano, Italy
| | - Elisabetta Xue
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Matteo Doglio
- Experimental Hematology Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milano, Italy
| | - Elena Tassi
- Experimental Hematology Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milano, Italy
| | | | - Andrea Acerbis
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Università Vita-Salute San Raffaele, Milano, Italy
| | - Daniela Clerici
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Francesca Farina
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Edoardo Campodonico
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Università Vita-Salute San Raffaele, Milano, Italy
| | - Alessandro Bruno
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Università Vita-Salute San Raffaele, Milano, Italy
| | - Simona Piemontese
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Sara Mastaglio
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Elisa Diral
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Raffaella Milani
- Immunohematology and Transfusion Medicine Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Annalisa Ruggeri
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Consuelo Corti
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Luca Vago
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Università Vita-Salute San Raffaele, Milano, Italy
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology IRCCS San Raffaele Hospital, Milano, Italy
| | - Chiara Bonini
- Università Vita-Salute San Raffaele, Milano, Italy
- Experimental Hematology Unit, IRCCS San Raffaele Hospital, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milano, Italy
| | - Jacopo Peccatori
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy
| | - Fabio Ciceri
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy.
- Università Vita-Salute San Raffaele, Milano, Italy.
| | | | - Raffaella Greco
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milano, Italy.
| |
Collapse
|
4
|
Noviello M, Lorentino F, Xue E, Racca S, Furnari G, Valtolina V, Campodonico E, Dvir R, Lupo-Stanghellini MT, Giglio F, Piemontese S, Clerici D, Oltolini C, Tassi E, Beretta V, Farina F, Mannina D, Ardemagni A, Vago L, Bernardi M, Corti C, Peccatori J, Clementi M, Ciceri F, Bonini C, Greco R. Human herpesvirus 6-specific T-cell immunity in allogeneic hematopoietic stem cell transplant recipients. Blood Adv 2023; 7:5446-5457. [PMID: 37067947 PMCID: PMC10515312 DOI: 10.1182/bloodadvances.2022009274] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Human herpesvirus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplant (allo-HSCT) and may lead to severe symptoms. HHV-6-specific immune responses after HSCT are largely unexplored. We conducted a prospective observational study on 208 consecutive adult patients who received allo-HSCT to investigate HHV-6 reactivations and specific immune responses. Interferon gamma-producing HHV-6-specific T cells were quantified using enzyme-linked immunospot assay (ELISpot). HHV-6 reactivation occurred in 63% of patients, at a median of 25 days from allo-HSCT. Only 40% of these presented a clinically relevant infection, defined by the presence of classical HHV-6 end-organ diseases (EODs), based on European Conference on Infections in Leukaemia (ECIL) guidelines, and other possible HHV6-related EODs. Using multivariate analysis, we identified risk factors for HHV-6 reactivation: previous allo-HSCT, posttransplant cyclophosphamide (PT-Cy), and time-dependent steroids introduction. The use of PT-Cy and steroids were associated with clinically relevant infections, whereas higher CD3+ cell counts seemed to be protective. Interestingly, circulating HHV-6-specific T cells were significantly higher in patients with reactivated virus. Moreover, HHV-6-specific T-cell responses, quantified at >4 days after the first viremia detection, predicted clinically relevant infections (P < .0001), with higher specificity (93%) and sensitivity (79%) than polyclonal CD3+ cells per μL. Overall survival and transplant-related mortality were not affected by time-dependent HHV-6 reactivation, whereas a significant association was observed between clinically relevant infections and acute graft-versus-host disease. These results shed light on the role of HHV-6 in allo-HSCT and may affect HHV-6 monitoring and treatment.
Collapse
Affiliation(s)
- Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Francesca Lorentino
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Elisabetta Xue
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Sara Racca
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | | | - Veronica Valtolina
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Edoardo Campodonico
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Roee Dvir
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | | | - Fabio Giglio
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Simona Piemontese
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Daniela Clerici
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Chiara Oltolini
- Infectious Disease Unit, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Elena Tassi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Valeria Beretta
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Francesca Farina
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Daniele Mannina
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Anna Ardemagni
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Luca Vago
- Università Vita-Salute San Raffaele, Milan, Italy
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Bernardi
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Consuelo Corti
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Jacopo Peccatori
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Fabio Ciceri
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Chiara Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Raffaella Greco
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| |
Collapse
|
5
|
Oltolini C, Acerbis A, Orofino G, Racca S, Noviello M, Dispinseri S, Clementi N, Piemontese S, Xue E, Giglio F, Lupo Stanghellini MT, Diral E, Bruno A, Tassi E, Beretta V, Marzinotto I, Scarlatti G, Lampasona V, Ardemagni A, Sampaolo M, Bonini C, Corti C, Peccatori J, Castagna A, Ciceri F, Greco R. Case Report: Favorable outcome of allogeneic hematopoietic stem cell transplantation in SARSCoV2 positive recipient, risk-benefit balance between infection and leukemia. Front Immunol 2023; 14:1184956. [PMID: 37287986 PMCID: PMC10242072 DOI: 10.3389/fimmu.2023.1184956] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) in SARS-CoV-2 positive candidates is usually delayed until the clinical resolution of the infection's symptoms and a negative nasopharyngeal molecular test. However, prolonged SARS-CoV-2 positivity has been frequently observed in haematological malignancies, thus representing a challenge for the timing of transplant procedures. Here, we report on the case of a 34-year-old patient with recent pauci-symptomatic COVID-19 undergoing transplant for high-risk acute B-lymphoblastic leukemia before achieving viral clearance. Shortly before their scheduled allogeneic HSCT from a matched unrelated donor, the patient developed mild Omicron BA.5 infection receiving nirmatrelvir/ritonavir with fever resolution within 72 hours. Twenty-three days after COVID-19 diagnosis, because of increasing minimal residual disease values in the context of high-risk refractory leukemia and clinical resolution of SARS-2-CoV infection with reduction of viral load at surveillance nasopharyngeal swabs, it was decided not to delay further allo-HSCT. During myelo-ablative conditioning, the nasopharyngeal SARS-CoV-2 viral load increased while the patient remained asymptomatic. Consequently, two days before the transplant, intra-muscular tixagevimab/cilgavimab 300/300 mg and a 3-day course of intravenous remdesivir were administered. During the pre-engraftment phase, veno-occlusive disease (VOD) occurred at day +13, requiring defibrotide treatment to obtain a slow but complete recovery. The post-engraftment phase was characterized by mild COVID-19 at day +23 (cough, rhino-conjunctivitis, fever) that spontaneously resolved, achieving viral clearance at day +28. At day +32, she experienced grade I acute graft-versus host disease (a-GVHD, skin grade II) treated with steroids and photo-apheresis, without further complications during follow-up until day +180. Addressing the issue of allo-HSCT timing in patients recovering from SARS-CoV-2 infection with high-risk malignant diseases is challenging because of 1] the high risk of COVID-19 clinical progression, 2] the impact of transplant delay on leukemia prognosis and 3] the occurrence of endothelial complications such as VOD, a-GVHD, and transplant associated thrombotic micro-angiopathy. Our report describes the favourable outcome of allo-HSCT in a recipient with active SARS-CoV2 infection and high-risk leukemia thanks to timely anti-SARS-CoV-2 preventive therapies and prompt management of transplant-related complications.
Collapse
Affiliation(s)
- Chiara Oltolini
- Clinic of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Acerbis
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Giorgio Orofino
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Sara Racca
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Maddalena Noviello
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Stefania Dispinseri
- Viral Evolution and Transmission Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- University Vita-Salute San Raffaele, Milan, Italy
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Simona Piemontese
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Xue
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Giglio
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Maria Teresa Lupo Stanghellini
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Diral
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Bruno
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Elena Tassi
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Beretta
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Ilaria Marzinotto
- Diabetes Research Institute Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Gabriella Scarlatti
- Viral Evolution and Transmission Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Vito Lampasona
- Diabetes Research Institute Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Anna Ardemagni
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Michela Sampaolo
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- University Vita-Salute San Raffaele, Milan, Italy
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Consuelo Corti
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Clinic of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Raffaella Greco
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
6
|
Sabetta E, Noviello M, Sciorati C, Viganò M, De Lorenzo R, Beretta V, Valtolina V, Di Resta C, Banfi G, Ferrari D, Locatelli M, Ciceri F, Bonini C, Rovere-Querini P, Tomaiuolo R. A longitudinal analysis of humoral, T cellular response and influencing factors in a cohort of healthcare workers: Implications for personalized SARS-CoV-2 vaccination strategies. Front Immunol 2023; 14:1130802. [PMID: 36999012 PMCID: PMC10043299 DOI: 10.3389/fimmu.2023.1130802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/22/2023] [Indexed: 03/15/2023] Open
Abstract
IntroductionSARS-CoV-2 mRNA vaccinations elicit both virus-specific humoral and T-cell responses, but a complex interplay of different influencing factors, such as natural immunity, gender, and age, guarantees host protection. The present study aims to assess the immune dynamics of humoral, T-cell response, and influencing factors to stratify individual immunization status up to 10 months after Comirnaty-vaccine administration.MethodsTo this aim, we longitudinally evaluated the magnitude and kinetics of both humoral and T-cell responses by serological tests and enzyme-linked immunospot assay at 5 time points. Furthermore, we compared the course over time of the two branches of adaptive immunity to establish an eventual correlation between adaptive responses. Lastly, we evaluated putative influencing factors collected by an anonymized survey administered to all participants through multiparametric analysis. Among 984 healthcare workers evaluated for humoral immunity, 107 individuals were further analyzed to describe SARS-CoV-2-specific T-cell responses. Participants were divided into 4 age groups: <40 and ≥40 years for men, <48 and ≥48 years for women. Furthermore, results were segregated according to SARS-CoV-2-specific serostatus at baseline.ResultsThe disaggregated evaluation of humoral responses highlighted antibody levels decreased in older subjects. The humoral responses were higher in females than in males (p=0.002) and previously virus-exposed subjects compared to naïve subjects (p<0.001). The vaccination induced a robust SARS-CoV-2 specific T-cell response at early time points in seronegative subjects compared to baseline levels (p<0.0001). However, a contraction was observed 6 months after vaccination in this group (p<0.01). On the other hand, the pre-existing specific T-cell response detected in natural seropositive individuals was longer-lasting than the response of the seronegative subjects, decreasing only 10 months after vaccination. Our data suggest that T-cell reactiveness is poorly impacted by sex and age. Of note, SARS-CoV-2-specific T-cell response was not correlated to the humoral response at any time point.DiscussionThese findings suggest prospects for rescheduling vaccination strategies by considering individual immunization status, personal characteristics, and the appropriate laboratory tests to portray immunity against SARS-CoV-2 accurately. Deepening our knowledge about T and B cell dynamics might optimize the decision-making process in vaccination campaigns, tailoring it to each specific immune response.
Collapse
Affiliation(s)
| | - Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Clara Sciorati
- Innate Immunity and Tissue Remodeling Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Viganò
- Scientific Direction, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | | | - Valeria Beretta
- Experimental Hematology Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Veronica Valtolina
- Experimental Hematology Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Giuseppe Banfi
- Vita-Salute San Raffaele University, Milan, Italy
- Scientific Direction, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | | | - Massimo Locatelli
- Laboratory Medicine Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Vita-Salute San Raffaele University, Milan, Italy
- Experimental Hematology Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy
- Innate Immunity and Tissue Remodeling Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- *Correspondence: Patrizia Rovere-Querini,
| | | |
Collapse
|
7
|
Greco R, Hoogenboom JD, Bonneville EF, Anagnostopoulos A, Cuoghi A, Dalle JH, Weissinger EM, Lang P, Galaverna F, Martino M, Maschan A, Mauz-Körholz C, Noviello M, Passweg J, Peccatori J, Rovira M, Solano C, Veelken H, Velardi A, Wagner-Drouet EM, Zhang X, Ciceri F, Bonini C, Vago L, Ruggeri A, Chabannon C. Monitoring for virus-specific T-cell responses and viremia in allogeneic HSCT recipients: a survey from the EBMT Cellular Therapy & Immunobiology Working Party. Bone Marrow Transplant 2023; 58:603-606. [PMID: 36813866 PMCID: PMC9944777 DOI: 10.1038/s41409-023-01939-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/05/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Affiliation(s)
- Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
| | | | - Edouard F. Bonneville
- grid.476306.0EBMT Leiden Study Unit, Leiden, The Netherlands ,grid.10419.3d0000000089452978Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Angela Cuoghi
- grid.413363.00000 0004 1769 5275Azienda Ospedaliero Universitaria di Modena Policlinico, Modena, Italy
| | | | - Eva M. Weissinger
- grid.10423.340000 0000 9529 9877Hannover Medical School, Hannover, Germany
| | - Peter Lang
- grid.411544.10000 0001 0196 8249University Hospital, Tuebingen, Germany
| | - Federica Galaverna
- grid.414125.70000 0001 0727 6809IRRCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Massimo Martino
- Grande Ospedale Metropolitano Bianchi Melacrino Morelli - Centro Unico Trapianti A. Neri, Reggio Calabria, Italy
| | - Alexei Maschan
- Federal Research Center for Pediatric Hematology, Moscow, Russia
| | - Christine Mauz-Körholz
- grid.8664.c0000 0001 2165 8627Justus-Liebig-University Giessen, Giessen, Germany ,grid.9018.00000 0001 0679 2801Medical Faculty of the Martin-Luther-University of Halle, Halle, Germany
| | - Maddalena Noviello
- grid.15496.3f0000 0001 0439 0892Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy
| | - Jakob Passweg
- grid.410567.1University Hospital, Basel, Switzerland
| | - Jacopo Peccatori
- grid.15496.3f0000 0001 0439 0892Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Montserrat Rovira
- grid.410458.c0000 0000 9635 9413BMT Unit, Hematology Department, ICMHO, IDIBAPS Hospital Clinic, Josep Carreras Institute, Barcelona, Spain
| | - Carlos Solano
- grid.411308.fHospital Clínico Universitario. University of Valencia, Valencia, Spain
| | - Hendrik Veelken
- grid.10419.3d0000000089452978Leiden University Hospital, Leiden, Netherlands
| | - Andrea Velardi
- grid.9027.c0000 0004 1757 3630Bone Marrow Transplantation Program, Division of Hematology and Clinical Immunology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | - Xi Zhang
- grid.410570.70000 0004 1760 6682Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Fabio Ciceri
- grid.15496.3f0000 0001 0439 0892Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milano, Italy
| | - Chiara Bonini
- grid.15496.3f0000 0001 0439 0892Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milano, Italy
| | - Luca Vago
- grid.15496.3f0000 0001 0439 0892Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milano, Italy ,grid.18887.3e0000000417581884Unit of Immunogenetics, Leukemia Genomics and Immunobiology, San Raffaele Scientific Institute, Milano, Italy
| | - Annalisa Ruggeri
- grid.15496.3f0000 0001 0439 0892Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Christian Chabannon
- grid.5399.60000 0001 2176 4817Institut Paoli-Calmettes, Centre de Lutte Contre le Cancer; Centre d’Investigations Cliniques en Biothérapies, Université d’Aix-Marseille, Inserm CBT, 1409 Marseille, France
| |
Collapse
|
8
|
Giglio F, Campodonico E, Lorentino F, Noviello M, Xue E, Greco R, Lazzari L, Bruno A, Lupo Stanghellini MT, Carrabba MG, La Starza R, Casucci M, Bonini C, Chiaretti S, Peccatori J, Foà R, Ciceri F. Case report: Ponatinib as a bridge to CAR-T cells and subsequent maintenance in a patient with relapsed/refractory Philadelphia-like acute lymphoblastic leukemia. Front Oncol 2023; 12:1100105. [PMID: 36733349 PMCID: PMC9888489 DOI: 10.3389/fonc.2022.1100105] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Philadelphia (Ph)-like acute lymphoblastic leukemia (ALL) constitutes a heterogeneous subset of ALL with a uniformly unfavorable prognosis. The identification of mutations amenable to treatment with tyrosine kinase-inhibitors (TKIs) represents a promising field of investigation. We report the case of a young patient affected by relapsed/refractory Ph-like ALL treated with chimeric antigen receptor T (CAR-T) cells after successful bridging with compassionate-use ponatinib and low-dose prednisone. We restarted low-dose ponatinib maintenance three months later. Twenty months later, measurable residual disease negativity and B-cell aplasia persist. To the best of our knowledge, this is the first case reporting the use of ponatinib in Ph-like ALL as a bridge to and maintenance after CAR-T cell therapy.
Collapse
Affiliation(s)
- Fabio Giglio
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy,Onco-hematology Unit, European Institute of Oncology, Milan, Italy,*Correspondence: Fabio Giglio,
| | - Edoardo Campodonico
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Francesca Lorentino
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy,PhD Program in Public Health Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Xue
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Greco
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Lazzari
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Bruno
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Matteo Giovanni Carrabba
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberta La Starza
- Cytogenetics and molecular medicine laboratory, department of Hematology and Clinical Immunology, University of Perugia, Perugia, Italy
| | - Monica Casucci
- Innovative Immunotherapies Unit - Division of Immunology, Transplantation and Infectious Diseases - IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy,Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Sabina Chiaretti
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
9
|
Tassi E, Noviello M, De Simone P, Lupo-Stanghellini MT, Doglio M, Serio F, Abbati D, Beretta V, Valtolina V, Oliveira G, Racca S, Campodonico E, Ruggiero E, Clerici D, Giglio F, Lorentino F, Dvir R, Xue E, Farina F, Oltolini C, Manfredi F, Vago L, Corti C, Bernardi M, Clementi M, Brix L, Ciceri F, Peccatori J, Greco R, Bonini C. Cytomegalovirus-specific T cells restricted for shared and donor human leukocyte antigens differentially impact on Cytomegalovirus reactivation risk after allogeneichematopoietic stem cell transplantation. Haematologica 2022. [PMID: 36200418 DOI: 10.3324/haematol.2022.280685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Indexed: 11/09/2022] Open
Abstract
After allogeneic hematopoietic stem cell transplantation (allo-HSCT), the emergence of circulating Cytomegalovirus(CMV)-specific T cells correlates with protection from CMV reactivation, an important risk factor for non-relapse mortality. However, functional assays measuring CMV-specific cells are time-consuming and often inaccurate at early timepoints. We report results of a prospective single-center non-interventional study which identifies the enumeration of Dextramer-positive CMV-specific lymphocytes as a reliable and early predictor of viral reactivation. We longitudinally monitored 75 consecutive patients for 1 year after allo-HSCT (n=630 samples). The presence of ≥0.5 CMV-specific CD8+ cells//L at day+45 was an independent protective factor from subsequent clinicallyrelevant reactivation in univariate(p.
Collapse
Affiliation(s)
- Elena Tassi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Pantaleo De Simone
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | | | - Matteo Doglio
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Francesca Serio
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Danilo Abbati
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Valeria Beretta
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Veronica Valtolina
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Giacomo Oliveira
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Sara Racca
- Laboratory of Clinical Microbiology and Virology, Ospedale San Raffaele Scientific Institute
| | - Edoardo Campodonico
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Eliana Ruggiero
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Daniela Clerici
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Fabio Giglio
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Francesca Lorentino
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Roee Dvir
- Laboratory of Clinical Microbiology and Virology, Ospedale San Raffaele Scientific Institute
| | - Elisabetta Xue
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Francesca Farina
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Chiara Oltolini
- Infectious Disease Unit, Ospedale San Raffaele Scientific Institute
| | - Francesco Manfredi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Luca Vago
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano; Università Vita-Salute San Raffaele
| | - Consuelo Corti
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Massimo Bernardi
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Massimo Clementi
- Laboratory of Clinical Microbiology and Virology, Ospedale San Raffaele Scientific Institute
| | | | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute, Milano; Università Vita-Salute San Raffaele
| | - Jacopo Peccatori
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Chiara Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano; Università Vita-Salute San Raffaele.
| |
Collapse
|
10
|
Guerrera G, Mandelli A, Finardi A, Orrico M, D'Orso S, Picozza M, Noviello M, Beretta V, Bonetti B, Calabrese M, Marastoni D, De Rossi N, Capra R, Salvetti M, Buscarinu MC, Inglese M, Uccelli A, Moiola L, Raposo C, Muros-Le Rouzic E, Pedotti R, Filippi M, Bonini C, Battistini L, Borsellino G, Furlan R. Anti-SARS-CoV-2 T-stem cell memory persists in ocrelizumab-treated MS patients. Mult Scler 2022; 28:1937-1943. [PMID: 35723265 DOI: 10.1177/13524585221102158] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Development of long-lasting anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) T-cell responses in persons with multiple sclerosis (pwMS) treated with ocrelizumab is questioned. OBJECTIVE Investigate antiviral T-cell responses after infection with SARS-CoV-2 in ocrelizumab-treated pwMS. Control groups included ocrelizumab-treated pwMS without SARS-CoV-2 infection, and non-MS individuals with and without SARS-CoV-2 infection. METHODS Peripheral blood mononuclear cells were stimulated with SARS-CoV-2 peptide pools and T-cell reactivity was assessed by ELISPOT for interferon (IFN)-γ detection, and by multiparametric fluorescence-activated cell sorting (FACS) analyses for assessment and characterization of T-cell activation. RESULTS ELISPOT assay against the spike and the N protein of SARS-CoV-2 displayed specific T-cell reactivity in 28/29 (96%) pwMS treated with ocrelizumab and infected by SARS-CoV-2, similar to infected persons without MS. This reactivity was present 1 year after infection and independent from the time of ocrelizumab infusion. FACS analysis following stimulation with SARS-CoV-2 peptide pools showed the presence of activation-induced markers (AIMs) in both CD4+ and CD8+ T-cell subsets in 96% and 92% of these individuals, respectively. Within naïve AIM+ CD4+ and CD8+ T-cells, we detected T memory stem cells, suggesting the acquisition of long-term memory. CONCLUSIONS B-cell depletion using ocrelizumab does not impair the development of long-lasting anti-SARS-CoV-2 T-cell responses.
Collapse
Affiliation(s)
| | - Alessandra Mandelli
- Division of Neuroscience, Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Annamaria Finardi
- Division of Neuroscience, Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mario Orrico
- Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Silvia D'Orso
- Neuroimmunology Unit, Fondazione Santa Lucia, Rome, Italy
| | - Mario Picozza
- Neuroimmunology Unit, Fondazione Santa Lucia, Rome, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Beretta
- Experimental Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Bruno Bonetti
- Dipartimento di Scienze Neurologiche e della Visione, Istituto di Neurologia Policlinico Borgo Roma, Universita di Verona, Verona, Italy
| | - Massimiliano Calabrese
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Neurology B, Regional Multiple Sclerosis Center, Università degli Studi di Verona, Verona, Italy
| | - Damiano Marastoni
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Neurology B, Regional Multiple Sclerosis Center, Università degli Studi di Verona, Verona, Italy
| | - Nicola De Rossi
- Multiple Sclerosis Centre, Spedali Civili di Brescia, Brescia, Italy
| | - Ruggero Capra
- Multiple Sclerosis Centre, Spedali Civili di Brescia, Brescia, Italy
| | | | | | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genova, Italy/IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genova, Italy
| | - Lucia Moiola
- Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | | | | | | | - Massimo Filippi
- Vita-Salute San Raffaele University, Milano, Italy/Neuroimaging Research Unit, Division of Neuroscience/Neurology Unit/Neurorehabilitation Unit/Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Experimental Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy/Vita-Salute San Raffaele University, Milano, Italy
| | | | | | - Roberto Furlan
- Division of Neuroscience, Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
11
|
Di Ciaula A, Bonfrate L, Portincasa P, Appice C, Belfiore A, Binetti M, Cafagna G, Campanale G, Carrieri A, Cascella G, Cataldi S, Cezza A, Ciannarella M, Cicala L, D'Alitto F, Dell'Acqua A, Dell'Anna L, Diaferia M, Erroi G, Fiermonte F, Galerati I, Giove M, Grimaldi L, Mallardi C, Mastrandrea E, Mazelli GD, Mersini G, Messina G, Messina M, Montesano A, Noto A, Novielli ME, Noviello M, Palma MV, Palmieri VO, Passerini F, Perez F, Piro C, Prigigallo F, Pugliese S, Rossi O, Stasi C, Stranieri R, Vitariello G. Nitrogen dioxide pollution increases vulnerability to COVID-19 through altered immune function. Environ Sci Pollut Res Int 2022; 29:44404-44412. [PMID: 35133597 PMCID: PMC9200946 DOI: 10.1007/s11356-022-19025-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/29/2022] [Indexed: 02/07/2023]
Abstract
Previous ecological studies suggest the existence of possible interplays between the exposure to air pollutants and SARS-CoV-2 infection. Confirmations at individual level, however, are lacking. To explore the relationships between previous exposure to particulate matter < 10 μm (PM10) and nitrogen dioxide (NO2), the clinical outcome following hospital admittance, and lymphocyte subsets in COVID-19 patients with pneumonia. In 147 geocoded patients, we assessed the individual exposure to PM10 and NO2 in the 2 weeks before hospital admittance. We divided subjects according to the clinical outcome (i.e., discharge at home vs in-hospital death), and explored the lymphocyte-related immune function as an index possibly affecting individual vulnerability to the infection. As compared with discharged subjects, patients who underwent in-hospital death presented neutrophilia, lymphopenia, lower number of T CD45, CD3, CD4, CD16/56 + CD3 + , and B CD19 + cells, and higher previous exposure to NO2, but not PM10. Age and previous NO2 exposure were independent predictors for mortality. NO2 concentrations were also negatively related with the number of CD45, CD3, and CD4 cells. Previous NO2 exposure is a co-factor independently affecting the mortality risk in infected individuals, through negative immune effects. Lymphopenia and altered lymphocyte subsets might precede viral infection due to nonmodifiable (i.e., age) and external (i.e., air pollution) factors. Thus, decreasing the burden of air pollutants should be a valuable primary prevention measure to reduce individual susceptibility to SARS-CoV-2 infection and mortality.
Collapse
Affiliation(s)
- Agostino Di Ciaula
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy.
- International Society of Doctors for Environment (ISDE), Arezzo, Italy.
| | - Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | | | - C Appice
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Belfiore
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Binetti
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Cafagna
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Campanale
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Carrieri
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Cascella
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - S Cataldi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Cezza
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Ciannarella
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - L Cicala
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F D'Alitto
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Dell'Acqua
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - L Dell'Anna
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Diaferia
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Erroi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Fiermonte
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - I Galerati
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Giove
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - L Grimaldi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - C Mallardi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - E Mastrandrea
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G D Mazelli
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Mersini
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Messina
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Messina
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Montesano
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - A Noto
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M E Novielli
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M Noviello
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - M V Palma
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - V O Palmieri
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Passerini
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Perez
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - C Piro
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - F Prigigallo
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - S Pugliese
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - O Rossi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - C Stasi
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - R Stranieri
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - G Vitariello
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| |
Collapse
|
12
|
Ruggeri L, Eikema DJ, Bondanza A, Noviello M, van Biezen A, de Wreede LC, Crucitti L, Vago L, Ciardelli S, Bader P, Koc Y, Locatelli F, Veelken JH, Gruhn B, Evans P, Chabannon C, Toubert A, Velardi A. Mother donors improve outcomes after HLA haploidentical transplantation: A Study by the Cellular Therapy and Immunobiology Working Party of the EBMT. Transplant Cell Ther 2022; 28:206.e1-206.e6. [PMID: 35017118 DOI: 10.1016/j.jtct.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/30/2021] [Accepted: 01/02/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Trans-placental trafficking of maternal and foetal cells during pregnancy establishes long-term, reciprocal micro-chimerism in both mother and child. As a consequence, the immune system of the mother may become sensitized to paternal histocompatibility antigens. It has been hypothesized that mother's "exposure" to paternal HLA haplotype antigens during pregnancy may affect transplantation outcomes when the mother acts as donor for the child. In T-cell depleted HLA haploidentical hematopoietic transplants, maternal donors have been shown to improve transplantation outcomes (Stern et al. Blood, 2008;112: 2990-2995). OBJECTIVES AND STUDY DESIGN The present retrospective multicenter study was conducted on behalf of Cellular Therapy and Immunobiology Working Party of the EBMT. It involved 409 patients (102 pediatric and 307 adult) with acute leukemia who were given HLA-haploidentical hematopoietic transplants. The goal of the study was to evaluate the role of maternal donors in a large cohort of haploidentical transplants. RESULTS Transplants from maternal donors were associated with lower relapse incidence in T-cell depleted (HR: 2.13 (1.16-3.92), p= 0.018) as well as in a limited series of unmanipulated, in vivo T-cell depleted transplants (HR: 4.15 (0.94-18.35), P=0.06) and also better graft-vs-host disease/relapse-free survival in T-cell depleted transplants (HR: 1.67 (1.02-2.73), p = 0.04). CONCLUSION These results indicate that the mother should be the preferred donor in order to provide better graft-vs-host disease/relapse-free survival in T-cell depleted HLA-haploidentical transplants for acute leukemia.
Collapse
Affiliation(s)
| | | | - Attilio Bondanza
- IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milano, Italy
| | - Maddalena Noviello
- IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milano, Italy
| | | | - Liesbeth C de Wreede
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Lara Crucitti
- IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milano, Italy
| | - Luca Vago
- IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milano, Italy
| | | | - Peter Bader
- Universitaetsklinikum Frankfurt Goethe-Universitaet, Frankfurt, Germany
| | - Yener Koc
- Medicana International Hospital, Istanbul, Turkey
| | - Franco Locatelli
- IRRCS Ospedale Pediatrico Bambino Gesů, Rome, Sapienza, University of Rome, Italy
| | | | - Bernd Gruhn
- Department of Pediatrics, Jena University Hospital, Jena, Germany
| | - Pamela Evans
- Children's Health Ireland at Crumlin, Crumlin, Dublin 12, Ireland
| | - Christian Chabannon
- Institut Paoli-Calmettes, Centre de Lutte Contre le Cancer; Centre d'Investigations Cliniques en Biothérapie, Université d'Aix-Marseille, Inserm CBT 1409, Marseille, France
| | - Antoine Toubert
- Université de Paris, Inserm U1160, Hôpital Saint-Louis, APHP, Paris, France
| | | |
Collapse
|
13
|
Siracusano G, Brombin C, Pastori C, Cugnata F, Noviello M, Tassi E, Princi D, Cantoni D, Malnati MS, Maugeri N, Bozzi C, Saretto G, Clementi N, Mancini N, Uberti-Foppa C, Temperton N, Bonini C, Di Serio C, Lopalco L. Profiling Antibody Response Patterns in COVID-19: Spike S1-Reactive IgA Signature in the Evolution of SARS-CoV-2 Infection. Front Immunol 2021; 12:772239. [PMID: 34804064 PMCID: PMC8595940 DOI: 10.3389/fimmu.2021.772239] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/14/2021] [Indexed: 11/27/2022] Open
Abstract
This contribution explores in a new statistical perspective the antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 141 coronavirus disease 2019 (COVID-19) patients exhibiting a broad range of clinical manifestations. This cohort accurately reflects the characteristics of the first wave of the SARS-CoV-2 pandemic in Italy. We determined the IgM, IgA, and IgG levels towards SARS-CoV-2 S1, S2, and NP antigens, evaluating their neutralizing activity and relationship with clinical signatures. Moreover, we longitudinally followed 72 patients up to 9 months postsymptoms onset to study the persistence of the levels of antibodies. Our results showed that the majority of COVID-19 patients developed an early virus-specific antibody response. The magnitude and the neutralizing properties of the response were heterogeneous regardless of the severity of the disease. Antibody levels dropped over time, even though spike reactive IgG and IgA were still detectable up to 9 months. Early baseline antibody levels were key drivers of the subsequent antibody production and the long-lasting protection against SARS-CoV-2. Importantly, we identified anti-S1 IgA as a good surrogate marker to predict the clinical course of COVID-19. Characterizing the antibody response after SARS-CoV-2 infection is relevant for the early clinical management of patients as soon as they are diagnosed and for implementing the current vaccination strategies.
Collapse
Affiliation(s)
- Gabriel Siracusano
- Division of Immunology, Transplantation and Infectious Disease, Immunobiology of HIV Group, San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Brombin
- University Centre of Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
| | - Claudia Pastori
- Division of Immunology, Transplantation and Infectious Disease, Immunobiology of HIV Group, San Raffaele Scientific Institute, Milan, Italy
| | - Federica Cugnata
- University Centre of Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Tassi
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Denise Princi
- Division of Immunology, Transplantation and Infectious Disease, Immunobiology of HIV Group, San Raffaele Scientific Institute, Milan, Italy
| | - Diego Cantoni
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham, United Kingdom
| | - Mauro S. Malnati
- Viral Evolution and Transmission Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Norma Maugeri
- Autoimmunity and Vascular Inflammation Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham, United Kingdom
| | - Chiara Bonini
- Experimental Hematology Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Clelia Di Serio
- University Centre of Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
- Biomedical Faculty, Università della Svizzera Italiana, Lugano, Switzerland
| | - Lucia Lopalco
- Division of Immunology, Transplantation and Infectious Disease, Immunobiology of HIV Group, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
14
|
Manfredi F, Abbati D, Cianciotti BC, Stasi L, Potenza A, Ruggiero E, Magnani Z, Carnevale E, Doglio M, Noviello M, Tassi E, Balestrieri C, Buonanno S, Clemente F, De Lalla C, Protti MP, Mondino A, Casorati G, Dellabona P, Bonini C. Flow cytometry data mining by cytoChain identifies determinants of exhaustion and stemness in TCR-engineered T cells. Eur J Immunol 2021; 51:1992-2005. [PMID: 34081326 DOI: 10.1002/eji.202049103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/03/2020] [Revised: 04/09/2021] [Accepted: 05/31/2021] [Indexed: 12/17/2022]
Abstract
The phenotype of infused cells is a major determinant of Adoptive T-cell therapy (ACT) efficacy. Yet, the difficulty in deciphering multiparametric cytometry data limited the fine characterization of cellular products. To allow the analysis of dynamic and complex flow cytometry samples, we developed cytoChain, a novel dataset mining tool and a new analytical workflow. CytoChain was challenged to compare state-of-the-art and innovative culture conditions to generate stem-like memory cells (TSCM ) suitable for ACT. Noticeably, the combination of IL-7/15 and superoxides scavenging sustained the emergence of a previously unidentified nonexhausted Fit-TSCM signature, overlooked by manual gating and endowed with superior expansion potential. CytoChain proficiently traced back this population in independent datasets, and in T-cell receptor engineered lymphocytes. CytoChain flexibility and function were then further validated on a published dataset from circulating T cells in COVID-19 patients. Collectively, our results support the use of cytoChain to identify novel, functionally critical immunophenotypes for ACT and patients immunomonitoring.
Collapse
Affiliation(s)
- Francesco Manfredi
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Danilo Abbati
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Lorena Stasi
- Vita Salute San Raffaele University, Milan, Italy
| | - Alessia Potenza
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Eliana Ruggiero
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Zulma Magnani
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Erica Carnevale
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Doglio
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Tassi
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Balestrieri
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Buonanno
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Claudia De Lalla
- Experimental Immunology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Pia Protti
- Tumor Immunology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Anna Mondino
- Lymphocyte Activation Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Casorati
- Experimental Immunology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Dellabona
- Experimental Immunology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Experimental Hematology Unit, San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| |
Collapse
|
15
|
Manfredi F, Cianciotti BC, Potenza A, Tassi E, Noviello M, Biondi A, Ciceri F, Bonini C, Ruggiero E. TCR Redirected T Cells for Cancer Treatment: Achievements, Hurdles, and Goals. Front Immunol 2020; 11:1689. [PMID: 33013822 PMCID: PMC7494743 DOI: 10.3389/fimmu.2020.01689] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/24/2020] [Indexed: 12/11/2022] Open
Abstract
Adoptive T cell therapy (ACT) is a rapidly evolving therapeutic approach designed to harness T cell specificity and function to fight diseases. Based on the evidence that T lymphocytes can mediate a potent anti-tumor response, initially ACT solely relied on the isolation, in vitro expansion, and infusion of tumor-infiltrating or circulating tumor-specific T cells. Although effective in a subset of cases, in the first ACT clinical trials several patients experienced disease progression, in some cases after temporary disease control. This evidence prompted researchers to improve ACT products by taking advantage of the continuously evolving gene engineering field and by improving manufacturing protocols, to enable the generation of effective and long-term persisting tumor-specific T cell products. Despite recent advances, several challenges, including prioritization of antigen targets, identification, and optimization of tumor-specific T cell receptors, in the development of tools enabling T cells to counteract the immunosuppressive tumor microenvironment, still need to be faced. This review aims at summarizing the major achievements, hurdles and possible solutions designed to improve the ACT efficacy and safety profile in the context of liquid and solid tumors.
Collapse
Affiliation(s)
- Francesco Manfredi
- Vita-Salute San Raffaele University, Milan, Italy.,Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Beatrice Claudia Cianciotti
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Fondazione Centro San Raffaele, Milan, Italy
| | - Alessia Potenza
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.,School of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
| | - Elena Tassi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Biondi
- Clinica Pediatrica Università degli Studi di Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy.,Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Vita-Salute San Raffaele University, Milan, Italy.,Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eliana Ruggiero
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
16
|
Toffalori C, Zito L, Gambacorta V, Riba M, Oliveira G, Bucci G, Barcella M, Spinelli O, Greco R, Crucitti L, Cieri N, Noviello M, Manfredi F, Montaldo E, Ostuni R, Naldini MM, Gentner B, Waterhouse M, Zeiser R, Finke J, Hanoun M, Beelen DW, Gojo I, Luznik L, Onozawa M, Teshima T, Devillier R, Blaise D, Halkes CJM, Griffioen M, Carrabba MG, Bernardi M, Peccatori J, Barlassina C, Stupka E, Lazarevic D, Tonon G, Rambaldi A, Cittaro D, Bonini C, Fleischhauer K, Ciceri F, Vago L. Immune signature drives leukemia escape and relapse after hematopoietic cell transplantation. Nat Med 2019; 25:603-611. [PMID: 30911134 DOI: 10.1038/s41591-019-0400-z] [Citation(s) in RCA: 228] [Impact Index Per Article: 45.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 02/15/2019] [Indexed: 01/17/2023]
Abstract
Transplantation of hematopoietic cells from a healthy individual (allogeneic hematopoietic cell transplantation (allo-HCT)) demonstrates that adoptive immunotherapy can cure blood cancers: still, post-transplantation relapses remain frequent. To explain their drivers, we analyzed the genomic and gene expression profiles of acute myeloid leukemia (AML) blasts purified from patients at serial time-points during their disease history. We identified a transcriptional signature specific for post-transplantation relapses and highly enriched in immune-related processes, including T cell costimulation and antigen presentation. In two independent patient cohorts we confirmed the deregulation of multiple costimulatory ligands on AML blasts at post-transplantation relapse (PD-L1, B7-H3, CD80, PVRL2), mirrored by concomitant changes in circulating donor T cells. Likewise, we documented the frequent loss of surface expression of HLA-DR, -DQ and -DP on leukemia cells, due to downregulation of the HLA class II regulator CIITA. We show that loss of HLA class II expression and upregulation of inhibitory checkpoint molecules represent alternative modalities to abolish AML recognition from donor-derived T cells, and can be counteracted by interferon-γ or checkpoint blockade, respectively. Our results demonstrate that the deregulation of pathways involved in T cell-mediated allorecognition is a distinctive feature and driver of AML relapses after allo-HCT, which can be rapidly translated into personalized therapies.
Collapse
Affiliation(s)
- Cristina Toffalori
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Laura Zito
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Valentina Gambacorta
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Unit of Senescence in Stem Cell Aging, Differentiation and Cancer, San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Michela Riba
- Center for Translational Genomics and Bioinformatics, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Giacomo Oliveira
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gabriele Bucci
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Center for Translational Genomics and Bioinformatics, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Matteo Barcella
- Genomic and Bioinformatics Unit, Department of Health Sciences, University of Milano, Milano, Italy
| | - Orietta Spinelli
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Lara Crucitti
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy.,University of Milano, Milano, Italy
| | - Nicoletta Cieri
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy.,University of Milano, Milano, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Francesco Manfredi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Elisa Montaldo
- Genomics of the Innate Immune System Unit, San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Renato Ostuni
- Genomics of the Innate Immune System Unit, San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Matteo M Naldini
- Translational Stem Cell and Leukemia Unit, San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Bernhard Gentner
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Translational Stem Cell and Leukemia Unit, San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Miguel Waterhouse
- Department of Hematology, Oncology and Stem Cell Transplantation, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Robert Zeiser
- Department of Hematology, Oncology and Stem Cell Transplantation, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Jurgen Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Maher Hanoun
- Department of Bone Marrow Transplantation, Universitätsklinikum Essen, Essen, Germany
| | - Dietrich W Beelen
- Department of Bone Marrow Transplantation, Universitätsklinikum Essen, Essen, Germany
| | - Ivana Gojo
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Leo Luznik
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Masahiro Onozawa
- Department of Hematology, Hokkaido University Faculty of Medicine, Graduate School of Medicine, Sapporo, Japan
| | - Takanori Teshima
- Department of Hematology, Hokkaido University Faculty of Medicine, Graduate School of Medicine, Sapporo, Japan
| | - Raynier Devillier
- Department of Haematology, Institut Paoli Calmettes, Marseille, France
| | - Didier Blaise
- Department of Haematology, Institut Paoli Calmettes, Marseille, France
| | | | - Marieke Griffioen
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Matteo G Carrabba
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Bernardi
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Jacopo Peccatori
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Cristina Barlassina
- Genomic and Bioinformatics Unit, Department of Health Sciences, University of Milano, Milano, Italy
| | - Elia Stupka
- Center for Translational Genomics and Bioinformatics, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dejan Lazarevic
- Center for Translational Genomics and Bioinformatics, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Giovanni Tonon
- Center for Translational Genomics and Bioinformatics, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Alessandro Rambaldi
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy.,Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy
| | - Davide Cittaro
- Center for Translational Genomics and Bioinformatics, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Chiara Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy.,San Raffaele Vita-Salute University, Milano, Italy
| | - Katharina Fleischhauer
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Institute for Experimental Cellular Therapy, Universitätsklinikum Essen, Essen, Germany
| | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy.,San Raffaele Vita-Salute University, Milano, Italy
| | - Luca Vago
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milano, Italy. .,Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy.
| |
Collapse
|
17
|
Smith E, Murphy M, Noviello M, Edward M, Koszewski W. College Athletes in North And South Carolina Desire Better Access to a Registered Dietitian Nutritionist in Order to Improve Athletic Performance. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.048] [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: 10/19/2022]
|
18
|
Cossu G, Previtali SC, Napolitano S, Cicalese MP, Tedesco FS, Nicastro F, Noviello M, Roostalu U, Natali Sora MG, Scarlato M, De Pellegrin M, Godi C, Giuliani S, Ciotti F, Tonlorenzi R, Lorenzetti I, Rivellini C, Benedetti S, Gatti R, Marktel S, Mazzi B, Tettamanti A, Ragazzi M, Imro MA, Marano G, Ambrosi A, Fiori R, Sormani MP, Bonini C, Venturini M, Politi LS, Torrente Y, Ciceri F. Intra-arterial transplantation of HLA-matched donor mesoangioblasts in Duchenne muscular dystrophy. EMBO Mol Med 2016; 8:1470-1471. [PMID: 27908983 PMCID: PMC6410420 DOI: 10.15252/emmm.201607129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
19
|
Greco R, Crucitti L, Noviello M, Racca S, Mannina D, Forcina A, Lorentino F, Valtolina V, Rolla S, Dvir R, Morelli M, Giglio F, Barbanti MC, Lupo Stanghellini MT, Oltolini C, Vago L, Scarpellini P, Assanelli A, Carrabba MG, Marktel S, Bernardi M, Corti C, Clementi M, Peccatori J, Bonini C, Ciceri F. Human Herpesvirus 6 Infection Following Haploidentical Transplantation: Immune Recovery and Outcome. Biol Blood Marrow Transplant 2016; 22:2250-2255. [PMID: 27697585 DOI: 10.1016/j.bbmt.2016.09.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 06/29/2016] [Accepted: 09/21/2016] [Indexed: 12/19/2022]
Abstract
Human herpesvirus 6 (HHV-6) is increasingly recognized as a potentially life-threatening pathogen in allogeneic hematopoietic stem cell transplantation (alloSCT). We retrospectively evaluated 54 adult patients who developed positivity to HHV-6 after alloSCT. The median time from alloSCT to HHV-6 reactivation was 34 days. HHV-6 was present in plasma samples from 31 patients, in bone marrow (BM) of 9 patients, in bronchoalveolar lavage fluid and liver or gut biopsy specimens from 33 patients, and in cerebrospinal fluid of 7 patients. Twenty-nine patients developed acute graft-versus-host disease (GVHD), mainly grade III-IV, and 15 had concomitant cytomegalovirus reactivation. The median absolute CD3+ lymphocyte count was 207 cells/µL. We reported the following clinical manifestations: fever in 43 patients, skin rash in 22, hepatitis in 19, diarrhea in 24, encephalitis in 10, BM suppression in 18, and delayed engraftment in 11. Antiviral pharmacologic treatment was administered to 37 patients; nonetheless, the mortality rate was relatively high in this population (overall survival [OS] at 1 year, 38% ± 7%). A better OS was significantly associated with a CD3+ cell count ≥200/µL at the time of HHV-6 reactivation (P = .0002). OS was also positively affected by the absence of acute GVHD grade III-IV (P = .03) and by complete disease remission (P = .03), but was not significantly influenced by steroid administration, time after alloSCT, type of antiviral prophylaxis, plasma viral load, or organ involvement. Although HHV-6 detection typically occurred early after alloSCT, better T cell immune reconstitution seems to have the potential to improve clinical outcomes. Our findings provide new insight into the interplay between HHV-6 and the transplanted immune system.
Collapse
Affiliation(s)
- Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Maddalena Noviello
- Experimental Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Racca
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniele Mannina
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandra Forcina
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Lorentino
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Veronica Valtolina
- Experimental Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Serena Rolla
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roee Dvir
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mara Morelli
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Giglio
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Chiara Barbanti
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Chiara Oltolini
- Infectious Disease Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Vago
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy; Unit of Immunogenetics, Leukemia, Genomics, and Immunobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Scarpellini
- Infectious Disease Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Assanelli
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo G Carrabba
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sarah Marktel
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Bernardi
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Consuelo Corti
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Jacopo Peccatori
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Experimental Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| |
Collapse
|
20
|
Cossu G, Previtali SC, Napolitano S, Cicalese MP, Tedesco FS, Nicastro F, Noviello M, Roostalu U, Natali Sora MG, Scarlato M, De Pellegrin M, Godi C, Giuliani S, Ciotti F, Tonlorenzi R, Lorenzetti I, Rivellini C, Benedetti S, Gatti R, Marktel S, Mazzi B, Tettamanti A, Ragazzi M, Imro MA, Marano G, Ambrosi A, Fiori R, Sormani MP, Bonini C, Venturini M, Politi LS, Torrente Y, Ciceri F. Intra-arterial transplantation of HLA-matched donor mesoangioblasts in Duchenne muscular dystrophy. EMBO Mol Med 2016; 7:1513-28. [PMID: 26543057 PMCID: PMC4693504 DOI: 10.15252/emmm.201505636] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Intra‐arterial transplantation of mesoangioblasts proved safe and partially efficacious in preclinical models of muscular dystrophy. We now report the first‐in‐human, exploratory, non‐randomized open‐label phase I–IIa clinical trial of intra‐arterial HLA‐matched donor cell transplantation in 5 Duchenne patients. We administered escalating doses of donor‐derived mesoangioblasts in limb arteries under immunosuppressive therapy (tacrolimus). Four consecutive infusions were performed at 2‐month intervals, preceded and followed by clinical, laboratory, and muscular MRI analyses. Two months after the last infusion, a muscle biopsy was performed. Safety was the primary endpoint. The study was relatively safe: One patient developed a thalamic stroke with no clinical consequences and whose correlation with mesoangioblast infusion remained unclear. MRI documented the progression of the disease in 4/5 patients. Functional measures were transiently stabilized in 2/3 ambulant patients, but no functional improvements were observed. Low level of donor DNA was detected in muscle biopsies of 4/5 patients and donor‐derived dystrophin in 1. Intra‐arterial transplantation of donor mesoangioblasts in human proved to be feasible and relatively safe. Future implementation of the protocol, together with a younger age of patients, will be needed to approach efficacy.
Collapse
Affiliation(s)
- Giulio Cossu
- Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Stefano C Previtali
- Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy Department of Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Napolitano
- HSR/TIGET Pediatric Clinical Research Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Pia Cicalese
- HSR/TIGET Pediatric Clinical Research Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Francesca Nicastro
- Laboratory of Analysis and Rehabilitation of Motor Function, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy Stem Cell Laboratory, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Urmas Roostalu
- Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | | | - Marina Scarlato
- Department of Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Claudia Godi
- Stem Cell Laboratory, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Neuroradiology Department and Neuroradiology Research Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Serena Giuliani
- Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Ciotti
- Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rossana Tonlorenzi
- Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Isabella Lorenzetti
- Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Rivellini
- Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Benedetti
- Department of Cell and Developmental Biology, University College London, London, UK
| | - Roberto Gatti
- Laboratory of Analysis and Rehabilitation of Motor Function, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sarah Marktel
- Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Benedetta Mazzi
- Immunogenetics Laboratory, Department of Immunohematology & Blood Transfusion, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Tettamanti
- Laboratory of Analysis and Rehabilitation of Motor Function, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Ragazzi
- Department of Cell and Developmental Biology, University College London, London, UK
| | | | | | | | - Rossana Fiori
- Unit of Anesthesiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Chiara Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Venturini
- Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Letterio S Politi
- Neuroradiology Department and Neuroradiology Research Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Yvan Torrente
- Stem Cell Laboratory, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Ciceri
- HSR/TIGET Pediatric Clinical Research Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
21
|
Noviello M, Forcina A, Veronica V, Crocchiolo R, Stanghellini MTL, Carrabba M, Greco R, Vago L, Giglio F, Assanelli A, Carbone MR, Magnani Z, Crippa F, Corti C, Bernardi M, Peccatori J, Bordignon C, Ciceri F, Bonini C, Bondanza A. Early recovery of CMV immunity after HLA-haploidentical hematopoietic stem cell transplantation as a surrogate biomarker for a reduced risk of severe infections overall. Bone Marrow Transplant 2015; 50:1262-4. [PMID: 26076126 DOI: 10.1038/bmt.2015.132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - A Forcina
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | | | - R Crocchiolo
- Department of Hematology, Humanitas Clinical Institute, Milan, Italy
| | - M T L Stanghellini
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - M Carrabba
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - R Greco
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - L Vago
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy.,Unit of Molecular and Functional Immunogenetics, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - F Giglio
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - A Assanelli
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - M R Carbone
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - Z Magnani
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - F Crippa
- Infectious Disease Unit, San Paolo Hospital, University of Milan, Milan, Italy
| | - C Corti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - M Bernardi
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - J Peccatori
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - C Bordignon
- Vita-Salute San Raffaele University, Milan, Italy.,MolMed S.p.a, Milan, Italy
| | - F Ciceri
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cell and Gene Therapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - C Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - A Bondanza
- Vita-Salute San Raffaele University, Milan, Italy.,Innovative Immunotherapies Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital Scientific Institute, Milan, Italy
| |
Collapse
|
22
|
Gullotta F, Noviello M, Stanco D, Andolfi G, Bernardo ME, Bonini MC, Banfi G, Peretti G, De Girolamo L, Dotti G, Gregori S, Bondanza A. Transgenic expression of IL-10 by lentiviral vectors for increasing the anti-inflammatory efficacy of mesenchymal stromal cells. J Biotechnol 2014. [DOI: 10.1016/j.jbiotec.2014.07.091] [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: 10/24/2022]
|
23
|
Peccatori J, Forcina A, Clerici D, Crocchiolo R, Vago L, Stanghellini MTL, Noviello M, Messina C, Crotta A, Assanelli A, Marktel S, Olek S, Mastaglio S, Giglio F, Crucitti L, Lorusso A, Guggiari E, Lunghi F, Carrabba M, Tassara M, Battaglia M, Ferraro A, Carbone MR, Oliveira G, Roncarolo MG, Rossini S, Bernardi M, Corti C, Marcatti M, Patriarca F, Zecca M, Locatelli F, Bordignon C, Fleischhauer K, Bondanza A, Bonini C, Ciceri F. Sirolimus-based graft-versus-host disease prophylaxis promotes the in vivo expansion of regulatory T cells and permits peripheral blood stem cell transplantation from haploidentical donors. Leukemia 2014; 29:396-405. [PMID: 24897508 DOI: 10.1038/leu.2014.180] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 04/14/2014] [Accepted: 05/19/2014] [Indexed: 01/05/2023]
Abstract
Hematopoietic stem cell transplantation (HSCT) from human leukocyte antigen (HLA) haploidentical family donors is a promising therapeutic option for high-risk hematologic malignancies. Here we explored in 121 patients, mostly with advanced stage diseases, a sirolimus-based, calcineurin-inhibitor-free prophylaxis of graft-versus-host disease (GvHD) to allow the infusion of unmanipulated peripheral blood stem cell (PBSC) grafts from partially HLA-matched family donors (TrRaMM study, Eudract 2007-5477-54). Conditioning regimen was based on treosulfan and fludarabine, and GvHD prophylaxis on antithymocyte globulin Fresenius (ATG-F), rituximab and oral administration of sirolimus and mycophenolate. Neutrophil and platelet engraftment occurred in median at 17 and 19 days after HSCT, respectively, and full donor chimerism was documented in patients' bone marrow since the first post-transplant evaluation. T-cell immune reconstitution was rapid, and high frequencies of circulating functional T-regulatory cells (Treg) were documented during sirolimus prophylaxis. Incidence of acute GvHD grade II-IV was 35%, and occurrence and severity correlated negatively with Treg frequency. Chronic GvHD incidence was 47%. At 3 years after HSCT, transpant-related mortality was 31%, relapse incidence 48% and overall survival 25%. In conclusion, GvHD prophylaxis with sirolimus-mycophenolate-ATG-F-rituximab promotes a rapid immune reconstitution skewed toward Tregs, allowing the infusion of unmanipulated haploidentical PBSC grafts.
Collapse
Affiliation(s)
- J Peccatori
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Forcina
- 1] Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy [2] Experimental Hematology Unit, Division of Immunology, Infectious Diseases and Transplants, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - D Clerici
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - R Crocchiolo
- 1] Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy [2] Humanitas Cancer Center, Rozzano, Italy
| | - L Vago
- 1] Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy [2] Unit of Molecular and Functional Immunogenetics, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M T L Stanghellini
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Noviello
- Experimental Hematology Unit, Division of Immunology, Infectious Diseases and Transplants, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Messina
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Crotta
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Assanelli
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Marktel
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Olek
- Epiontis GmbH, Berlin, Germany
| | - S Mastaglio
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Giglio
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Crucitti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Lorusso
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - E Guggiari
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Lunghi
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Carrabba
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Tassara
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Battaglia
- San Raffaele Diabetes Research Institute, Division of Immunology, Infectious Diseases and Transplants, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Ferraro
- San Raffaele Diabetes Research Institute, Division of Immunology, Infectious Diseases and Transplants, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M R Carbone
- Experimental Hematology Unit, Division of Immunology, Infectious Diseases and Transplants, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - G Oliveira
- Experimental Hematology Unit, Division of Immunology, Infectious Diseases and Transplants, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M G Roncarolo
- 1] Pediatric Immunology, Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy [2] San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), Division of Regenerative Medicine, Gene Therapy and Stem Cells, San Raffaele Scientific Institute, Milan, Italy [3] 'Vita-Salute' San Raffaele University, Milan, Italy
| | - S Rossini
- Immunohematology and Transfusion Medicine Service, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Bernardi
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Corti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Marcatti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Patriarca
- Clinica Ematologica, Policlinico Universitario, Udine, Italy
| | - M Zecca
- Policlinico San Matteo, Pavia, Italy
| | | | - C Bordignon
- 1] 'Vita-Salute' San Raffaele University, Milan, Italy [2] MolMed SpA, Milan, Italy
| | - K Fleischhauer
- Unit of Molecular and Functional Immunogenetics, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Bondanza
- 1] Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy [2] Leukemia Immunotherapy Group, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Bonini
- Experimental Hematology Unit, Division of Immunology, Infectious Diseases and Transplants, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Ciceri
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Gene Therapy and Stem Cells, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
24
|
Forcina A, Noviello M, Carbone MR, Bonini C, Bondanza A. Predicting the Clinical Outcome of Allogeneic Hematopoietic Stem Cell Transplantation: The Long and Winding Road toward Validated Immune Biomarkers. Front Immunol 2013; 4:71. [PMID: 23531639 PMCID: PMC3607069 DOI: 10.3389/fimmu.2013.00071] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 03/04/2013] [Indexed: 12/04/2022] Open
Abstract
The clinical outcome of allogeneic hematopoietic stem cell transplantation (HSCT) is strongly influenced from the potential complications arising during the delicate phase of post-transplant immune restoration. The quantitative aspects of immune-cell repopulation after HSCT and the qualitative features their functional restitution have been extensively reported. Nevertheless, measurable immune biomarkers predicting the clinical outcome of HSCT await formal validation. The aim of this review is an appraisal of most studies published so far on the predictive value of different T and NK-cell biomarkers after HSCT with emphasis on defined thresholds endorsed by multivariate analysis.
Collapse
Affiliation(s)
- A Forcina
- Experimental Hematology Unit, San Raffaele Scientific Institute Milan, Italy
| | | | | | | | | |
Collapse
|
25
|
Bordignon C, Vago L, Oliveira G, Noviello M, Soldati C, Ghio D, Brigida I, Aiuti A, Lupo-Stanghellini MT, Peccatori J, Lambiase A, Bondanza A, Del Maschio A, Ciceri F, Bonini C. Mechanism of thymic renewal after infusion of suicide gene-modified donor T cells after hematopoietic stem cell transplantation (HSCT) in adult patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6526] [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
|
26
|
Oliveira G, Vago L, Noviello M, Soldati C, Ghio D, Brigida I, Aiuti A, Lupo Stanghellini MT, Peccatori J, Bondanza A, Del Maschio A, Bordignon C, Ciceri F, Bonini C. The infusion of suicide gene-modified donor T cells after hematopoietic stem cell transplantation prompts thymic renewal in adult patients by an IL-7 dependent mechanism (169.4). The Journal of Immunology 2011. [DOI: 10.4049/jimmunol.186.supp.169.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
The infusion of donor lymphocytes genetically modified to express the HSV-Thymidine kinase (Tk) suicide gene after T cell-depleted Hematopoietic Stem Cell Transplanation (HSCT) provides protection against pathogens and disease recurrence, while allowing complete GvHD control. In the TK007 phase I/II clinical trial 28 adults with hematologic malignancies received purified Tk-transduced cells after T cell-depleted haploidentical HSCT, and 22 experienced a rapid immune reconstitution. Ten patients had GvHD that was controlled by ganciclovir (Lancet Oncol. 2009). Since the newly reconstituting T cells were mostly Tkneg, we hypothesized that Tk cells, which are necessary to achieve this effect, might act by prompting T cell development from graft progenitors. Patients treated with Tk cells showed prompt recovery of Tkneg naïve T cells. In particular, the CD4+ naïve subset was highly enriched in CD31+ cells, bona fide recent thymic emigrants. Accordingly, after Tk cell add-backs we documented an increase in single joint T cell Receptor Excision Circles counts and in thymic volume, as evidenced by chest CT scans. Serum levels of IL-7 markedly rose after Tk cell add-backs, suggesting that gene-modified cells may act by inducing IL-7 release, in turn supporting thymopoiesis. Taken together, our data show that the infusion of Tk cells boosts the function of adult thymus, prompting the recovery of a polyclonal, fully competent, T cell repertoire by an IL-7 dependent mechanism.
Collapse
Affiliation(s)
| | - Luca Vago
- 1San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | | | | | | | | | | | | | - Claudio Bordignon
- 2"Vita-Salute" San Raffaele University, Milan, Italy
- 3Molmed SpA, Milan, Italy
| | - Fabio Ciceri
- 1San Raffaele Scientific Institute, Milan, Italy
| | | |
Collapse
|