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Ruggeri L, Parisi S, Urbani E, Curti A. Alloreactive Natural Killer Cells for the Treatment of Acute Myeloid Leukemia: From Stem Cell Transplantation to Adoptive Immunotherapy. Front Immunol 2015; 6:479. [PMID: 26528283 PMCID: PMC4606119 DOI: 10.3389/fimmu.2015.00479] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/03/2015] [Indexed: 01/11/2023] Open
Abstract
Natural killer (NK) cells express activating and inhibitory receptors, which recognize MHC class-I alleles, termed “Killer cell Immunoglobulin-like Receptors” (KIRs). Preclinical and clinical data from haploidentical T-cell-depleted stem cell transplantation have demonstrated that alloreactive KIR-L mismatched NK cells play a major role as effectors against acute myeloid leukemia (AML). Outside the transplantation setting, several reports have proven the safety and feasibility of NK cell infusion in AML patients and, in some cases, provided evidence that transferred NK cells are functionally alloreactive and may have a role in disease control. The aim of the present work is to briefly summarize the most recent advances in the field by moving from the first preclinical and clinical demonstration of donor NK alloreactivity in the transplantation setting to the most recent attempts at exploiting the use of alloreactive NK cell infusion as a means of adoptive immunotherapy against AML. Altogether, these data highlight the pivotal role of NK cells for the development of novel immunological approaches in the clinical management of AML.
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Affiliation(s)
- Loredana Ruggeri
- Department of Medicine, Division of Hematology and Clinical Immunology, Ospedale Santa Maria della Misericordia, University of Perugia , Perugia , Italy
| | - Sarah Parisi
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology "L. and A. Seràgnoli", S. Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Elena Urbani
- Department of Medicine, Division of Hematology and Clinical Immunology, Ospedale Santa Maria della Misericordia, University of Perugia , Perugia , Italy
| | - Antonio Curti
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology "L. and A. Seràgnoli", S. Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
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202
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Wu S, Zeng YJ, Zhang C, Deng TX, Xu YQ, Zhang X. The role of the killer cell immunoglobulin-like receptor (KIR) "missing self" model in unrelated donor HSCT: a meta-analysis. Transplant Proc 2015; 47:558-65. [PMID: 25769607 DOI: 10.1016/j.transproceed.2015.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 01/10/2015] [Accepted: 01/28/2015] [Indexed: 12/29/2022]
Abstract
Some studies have found that donor-recipient killer cell immunoglobulin g-like receptor (KIRs) ligand compatibility or incompatibility influences the prognosis of hematopoietic stem cell transplantation between unrelated individuals, although the conclusions of these studies are controversial. We performed a meta-analysis concerning unrelated donor transplantation with donor-recipient KIRs compatible or incompatible. A higher 5-year overall survival rate (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.03 to 3.61, P = .04) was found in KIR-mismatched transplantations; however, no difference was observed in the incidence of grade 2 to 4 acute graft-vs-host disease (OR = 0.94, 95% CI = 0.71 to 1.24, P = .64), 5-year relapse rate (OR = 1.05, CI = 0.75 to 1.47, P = .77), or transplantation/treatment-related mortality (OR = 0.61, CI = 0.15 to 2.51, P = .50). Our meta-analysis confirmed that incompatibility in KIR ligands favors 5-year overall survival rate but has no effect on the incidence of grade 2 to 4 acute graft-vs-host disease, relapse, or transplantation/treatment-related mortality.
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Affiliation(s)
- S Wu
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Y J Zeng
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - C Zhang
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - T X Deng
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Y Q Xu
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - X Zhang
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China.
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203
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Park S, Kim K, Jang JH, Kim SJ, Kim WS, Kang ES, Jung CW. KIR alloreactivity based on the receptor-ligand model is associated with improved clinical outcomes of allogeneic hematopoietic stem cell transplantation: Result of single center prospective study. Hum Immunol 2015; 76:636-43. [PMID: 26407827 DOI: 10.1016/j.humimm.2015.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 12/30/2022]
Abstract
Receptors on natural killer (NK) cells, named killer immunoglobulin-like receptors (KIRs), recognize HLA class I alleles. Patients (n=59) who received allogeneic hematopoietic stem cell transplantation (HSCT) from either a related (n=17) or unrelated donor (n=42) in Samsung Medical Center (Seoul, South Korea) were included. KIR mismatch was defined as incompatibility between the donor KIR and recipient KIR ligand (receptor-ligand model), and all cases were classified into the two broad haplotypes of KIR A and B. Patients with acute leukemia (n=51, 86.4%) or myelodysplastic syndrome (n=8, 13.6%) were included. Peripheral blood was used as the source of stem cells in all patients. Kaplan-Meier survival curves for overall survival (OS), disease-free survival (DFS), and cumulative incidence of relapse (CIR) favored recipients with a KIR-mismatched donor, although the differences were not statistically significant. In multivariate analysis, KIR mismatch was an independent prognostic indicator of a better OS (P=0.010, HR=0.148, 95% CI 0.034-0.639), DFS (P=0.022, HR=0.237, 95% CI 0.069-0.815), and CIR (P=0.031, HR=0.117, 95% CI 0.017-0.823). OS, DFS, and CIR did not differ significantly between the KIR A and B haplotypes.
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Affiliation(s)
- Silvia Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea
| | - Kihyun Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea
| | - Jun Ho Jang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea
| | - Seok Jin Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
| | - Chul Won Jung
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
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204
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Sarkar S, van Gelder M, Noort W, Xu Y, Rouschop KMA, Groen R, Schouten HC, Tilanus MGJ, Germeraad WTV, Martens ACM, Bos GMJ, Wieten L. Optimal selection of natural killer cells to kill myeloma: the role of HLA-E and NKG2A. Cancer Immunol Immunother 2015; 64:951-63. [PMID: 25920521 PMCID: PMC4506464 DOI: 10.1007/s00262-015-1694-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 03/27/2015] [Indexed: 12/30/2022]
Abstract
Immunotherapy with allogeneic natural killer (NK) cells offers therapeutic perspectives for multiple myeloma patients. Here, we aimed to refine NK cell therapy by evaluation of the relevance of HLA-class I and HLA-E for NK anti-myeloma reactivity. We show that HLA-class I was strongly expressed on the surface of patient-derived myeloma cells and on myeloma cell lines. HLA-E was highly expressed by primary myeloma cells but only marginally by cell lines. HLA-E(low) expression on U266 cells observed in vitro was strongly upregulated after in vivo (bone marrow) growth in RAG-2(-/-) γc(-/-) mice, suggesting that in vitro HLA-E levels poorly predict the in vivo situation. Concurrent analysis of inhibitory receptors (KIR2DL1, KIR2DL2/3, KIR3DL1 and NKG2A) and NK cell degranulation upon co-culture with myeloma cells revealed that KIR-ligand-mismatched NK cells degranulate more than matched subsets and that HLA-E abrogates degranulation of NKG2A+ subsets. Inhibition by HLA-class I and HLA-E was also observed with IL-2-activated NK cells and at low oxygen levels (0.6 %) mimicking hypoxic bone marrow niches where myeloma cells preferentially reside. Our study demonstrates that NKG2A-negative, KIR-ligand-mismatched NK cells are the most potent subset for clinical application. We envision that infusion of high numbers of this subclass will enhance clinical efficacy.
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Affiliation(s)
- Subhashis Sarkar
- />Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Michel van Gelder
- />Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Willy Noort
- />Department of Cell Biology, University Medical Center Utrecht, Utrecht, The Netherlands
- />Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - Yunping Xu
- />Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Center+, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Kasper M. A. Rouschop
- />Department of Radiation Oncology (Maastro Lab), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Richard Groen
- />Department of Cell Biology, University Medical Center Utrecht, Utrecht, The Netherlands
- />Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - Harry C. Schouten
- />Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Marcel G. J. Tilanus
- />Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Center+, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Wilfred T. V. Germeraad
- />Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Anton C. M. Martens
- />Department of Cell Biology, University Medical Center Utrecht, Utrecht, The Netherlands
- />Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- />Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - Gerard M. J. Bos
- />Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Lotte Wieten
- />Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Center+, PO box 5800, 6202 AZ Maastricht, The Netherlands
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205
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Umbilical cord blood-derived mesenchymal stem cells ameliorate graft-versus-host disease following allogeneic hematopoietic stem cell transplantation through multiple immunoregulations. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s11596-015-1456-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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206
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Abstract
We have developed a rapid negative selection method to enrich rare mononuclear cells from human tissues. Unwanted and antibody-tethered cells are selectively depleted during a Ficoll separation step, and there is no need for magnetic-based reagents and equipment. The new method is fast, customizable, inexpensive, remarkably efficient, and easy to perform, and per sample the overall cost is less than one-tenth the cost associated with a magnetic column-based method.
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207
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Bastos-Oreiro M, Anguita J, Martínez-Laperche C, Fernández L, Buces E, Navarro A, Pascual C, Pérez-Corral A, Balsalobre P, Muñoz C, Kwon M, Serrano D, Perez-Martinez A, Buño I, Gayoso J, Díez-Martín JL. Inhibitory killer cell immunoglobulin-like receptor (iKIR) mismatches improve survival after T-cell-repleted haploidentical transplantation. Eur J Haematol 2015; 96:483-91. [PMID: 26133015 DOI: 10.1111/ejh.12616] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2015] [Indexed: 11/26/2022]
Abstract
Alloreactivity triggered by interaction between killer cell immunoglobulin-like receptors (KIRs) and natural killer (NK) cells plays a role in the graft-versus-tumor effect after hematopoietic stem cell transplantation (SCT). Our aim in this study was to evaluate this role in the setting of T-cell-repleted haploidentical SCT with postinfusion high-dose cyclophosphamide (PT-Cy). We included 33 patients. Among patient-donor pairs with at least 1 inhibitory KIR (iKIR) gene mismatch, event-free survival (EFS) and cumulative incidence of relapse 1 year after transplant were significantly better (85% vs. 37% [P = 0.008] and 18% vs. 46% [P = 0.041], respectively). A subanalysis in 12 patients with Hodgkin's lymphoma (HL) showed an improvement in EFS 1 year after transplant in those patients with KIR ligand mismatch (100% vs. 25%, P = 0.012), although overall survival (OS) was not affected (85% vs. 80%, P = 0.2). Eight of 12 patient-donors pairs presented iKIR mismatches. Of note, this outcome was better in the small subgroup, both for EFS (100% vs. 25%, P = 0.012) and for OS (100% vs. 37%, P = 0.004). Our data suggest that in the setting of T-cell-repleted haploidentical SCT with PT-Cy, iKIR mismatch is associated with improved survival, with particularly good results for both iKIR and KIR ligand mismatches in patients with HL.
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Affiliation(s)
- Mariana Bastos-Oreiro
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Javier Anguita
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Carolina Martínez-Laperche
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Lucía Fernández
- Programa de investigación clínica, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Elena Buces
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Almudena Navarro
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Pascual
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Pérez-Corral
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Pascual Balsalobre
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Cristina Muñoz
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Mi Kwon
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - David Serrano
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Ismael Buño
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Jorge Gayoso
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - José Luís Díez-Martín
- Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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208
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Abstract
PURPOSE OF REVIEW To describe the current management of de-novo pediatric acute myeloid leukemia (AML), excluding promyelocytic leukemia and myeloid neoplasms of patients with constitutional trisomy 21. The biology of pediatric AML, which differs from that of its adult counterpart, is briefly discussed. RECENT FINDINGS Although survival of childhood AML has improved substantially over the past 40 years, progress has reached a plateau. Pediatric AML comprises several subtypes with diverse prognosis. Currently, about 35% of patients die of the disease, and survivors have many debilitating late effects. Clinical trials reported over the past 5 years have revealed several therapeutic concepts. First, initial intensive myelosuppressive chemotherapy is necessary to sufficiently reduce minimal residual disease and is associated with improved disease-free survival. Second, postremission chemotherapy with or without hematopoietic stem cell transplantation is necessary to eradicate AML. Third, central nervous system leukemia can be adequately managed with intrathecal chemotherapy and rarely requires radiotherapy. Finally, small differences in survival among clinical trials are explained by patient selection and quality of supportive care. SUMMARY The most crucial steps for progress are greater understanding of the biology of pediatric AML and introduction of new agents targeting specific AML subtypes and age-specific factors.
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209
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Schlegel P, Ditthard K, Lang P, Mezger M, Michaelis S, Handgretinger R, Pfeiffer M. NKG2D Signaling Leads to NK Cell Mediated Lysis of Childhood AML. J Immunol Res 2015; 2015:473175. [PMID: 26236752 PMCID: PMC4510257 DOI: 10.1155/2015/473175] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 06/09/2015] [Accepted: 06/16/2015] [Indexed: 01/24/2023] Open
Abstract
Natural killer cells have been shown to be relevant in the recognition and lysis of acute myeloid leukemia. In childhood acute lymphoblastic leukemia, it was shown that HLA I expression and KIR receptor-ligand mismatch significantly impact ALL cytolysis. We characterized 14 different primary childhood AML blasts by flow cytometry including NKG2D ligands. Further HLA I typing of blasts was performed and HLA I on the AML blasts was quantified. In two healthy volunteer NK cell donors HLA I typing and KIR genotyping were done. Blasts with high NKG2D ligand expression had significantly higher lysis by isolated NK cells. Grouping the blasts by NKG2D ligand expression led to a significant inverse correlation of HLA I expression and cytolysis in NKG2D low blasts. Furthermore, a significant positive correlation of NKG2D ligand expression and blast cytolysis was shown. No impact of KIR ligand-ligand mismatch was found but a significantly increased lysis of homozygous C2 blasts by KIR2DL1 negative NK cells (donor B) was revealed. In conclusion, NKG2D signaling leads to NK cell mediated lysis of childhood AML despite high HLA I expression.
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MESH Headings
- Case-Control Studies
- Cell Line, Tumor
- Child
- Cytotoxicity, Immunologic
- Gene Expression
- Histocompatibility Antigens Class I/genetics
- Histocompatibility Antigens Class I/immunology
- Humans
- Immunophenotyping
- K562 Cells
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/pathology
- Ligands
- NK Cell Lectin-Like Receptor Subfamily K/genetics
- NK Cell Lectin-Like Receptor Subfamily K/metabolism
- Phenotype
- Signal Transduction
- HLA-E Antigens
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Affiliation(s)
- Patrick Schlegel
- Department of Hematology and Oncology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany
| | - Kerstin Ditthard
- Department of Hematology and Oncology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany
| | - Peter Lang
- Department of Hematology and Oncology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany
| | - Markus Mezger
- Department of Hematology and Oncology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany
| | - Sebastian Michaelis
- Department of Hematology and Oncology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany
| | - Rupert Handgretinger
- Department of Hematology and Oncology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany
| | - Matthias Pfeiffer
- Department of Hematology and Oncology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany
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210
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Grosso DA, Hess RC, Weiss MA. Immunotherapy in acute myeloid leukemia. Cancer 2015; 121:2689-704. [PMID: 26095886 DOI: 10.1002/cncr.29378] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 01/23/2015] [Accepted: 02/09/2015] [Indexed: 11/08/2022]
Abstract
Despite the remarkable progress made in some leukemias such as CML and CLL, cytotoxic treatment for AML remains essentially unchanged over the last 4 decades. Several lines of evidence, including the graft versus leukemia effect associated with allogeneic hematopoietic stem cell transplantation (HSCT), suggest that immunotherapy is an active modality in AML. Given the lack of progress for chemotherapy in this disease, many novel immunologic treatment approaches have been explored. The goals of non-transplant-based immune approaches have largely consisted of the stimulation or restoration of endogenous immune responses or the targeting of specific tumor antigens by immune cells. These strategies have been associated with less toxicity than allogeneic HSCT but typically have inferior efficacy. Allogeneic HSCT exploits major and minor histocompatibility differences between the donor and recipient in order to recognize and eradicate malignancy. With the recognition that the immune system itself provides a basis for treating AML, immunotherapy continues to be an attractive modality to exploit in the treatment of this disease.
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Affiliation(s)
- Dolores A Grosso
- Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rosemary C Hess
- Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mark A Weiss
- Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
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211
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T-cell depletion: from positive selection to negative depletion in adult patients. Bone Marrow Transplant 2015; 50 Suppl 2:S11-3. [DOI: 10.1038/bmt.2015.88] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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212
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Lim O, Jung MY, Hwang YK, Shin EC. Present and Future of Allogeneic Natural Killer Cell Therapy. Front Immunol 2015; 6:286. [PMID: 26089823 PMCID: PMC4453480 DOI: 10.3389/fimmu.2015.00286] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/18/2015] [Indexed: 01/04/2023] Open
Abstract
Natural killer (NK) cells are innate lymphocytes that are capable of eliminating tumor cells and are therefore used for cancer therapy. Although many early investigators used autologous NK cells, including lymphokine-activated killer cells, the clinical efficacies were not satisfactory. Meanwhile, human leukocyte antigen (HLA)-haploidentical hematopoietic stem cell transplantation revealed the antitumor effect of allogeneic NK cells, and HLA-haploidentical, killer cell immunoglobulin-like receptor ligand-mismatched allogeneic NK cells are currently used for many protocols requiring NK cells. Moreover, allogeneic NK cells from non-HLA-related healthy donors have been recently used in cancer therapy. The use of allogeneic NK cells from non-HLA-related healthy donors allows the selection of donor NK cells with higher flexibility and to prepare expanded, cryopreserved NK cells for instant administration without delay for ex vivo expansion. In cancer therapy with allogeneic NK cells, optimal matching of donors and recipients is important to maximize the efficacy of the therapy. In this review, we summarize the present state of allogeneic NK cell therapy and its future directions.
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Affiliation(s)
- Okjae Lim
- Virology and Immunology Team, MOGAM Biotechnology Institute , Yongin , South Korea
| | - Mi Young Jung
- Virology and Immunology Team, MOGAM Biotechnology Institute , Yongin , South Korea
| | - Yu Kyeong Hwang
- Cell Therapy Center, GreenCross LabCell , Yongin , South Korea
| | - Eui-Cheol Shin
- Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST , Daejeon , South Korea
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213
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Zhao XY, Chang YJ, Zhao XS, Xu LP, Zhang XH, Liu KY, Li D, Huang XJ. Recipient expression of ligands for donor inhibitory KIRs enhances NK-cell function to control leukemic relapse after haploidentical transplantation. Eur J Immunol 2015; 45:2396-408. [PMID: 25952732 DOI: 10.1002/eji.201445057] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 03/20/2015] [Accepted: 05/05/2015] [Indexed: 11/06/2022]
Abstract
Natural killer (NK) cells that express self-HLA-specific receptors (where HLA is human leukocyte antigen) are "licensed" and more readily activated than unlicensed cells; therefore, NK-cell licensing could influence the antileukemia effects of NK cells following haploidentical stem cell transplantation (haplo-SCT). In this study, we compared the functionality of reconstituting NK cells, based on CD107α expression and interferon-γsecretion, in a cohort of 29 patients that expressed (n = 8) or lacked (n = 21) class I human leukocyte antigens for donor inhibitory killer cell immunoglobulin-like receptors (KIRs) following T-cell-replete haplo-SCT. We also addressed whether recipient expression of class I ligands for donor inhibitory KIRs could predict relapse occurrence in another cohort of 188 patients. A longitudinal analysis indicated that patients presenting class I for all donor inhibitory KIRs showed more capable functional NK effector cells when tested against class I negative K562 cells and primary leukemic cells within 3 months of transplantation. The lowest 7-year relapse incidence was observed when donor KIRs were ligated by recipient class I (n = 60) compared with donor-host partnerships where donor KIR(+) cells were ligated by donor, but not recipient class I (n = 86, p = 0.026) or KIRs that were ligated by neither donor nor recipient class I (n = 42, p = 0.043). This study suggests that haplo-SCT recipients presenting class I for donor inhibitory KIRs promote NK-cell licensing, leading to decreased relapse rates.
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Affiliation(s)
- Xiang-Yu Zhao
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Ying-Jun Chang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Su Zhao
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Lan-Ping Xu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Hui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Kai-Yan Liu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Dan Li
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
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Cany J, van der Waart AB, Spanholtz J, Tordoir M, Jansen JH, van der Voort R, Schaap NM, Dolstra H. Combined IL-15 and IL-12 drives the generation of CD34 +-derived natural killer cells with superior maturation and alloreactivity potential following adoptive transfer. Oncoimmunology 2015; 4:e1017701. [PMID: 26140247 DOI: 10.1080/2162402x.2015.1017701] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 01/24/2023] Open
Abstract
Adoptive transfer of allogeneic natural killer (NK) cells represents a promising treatment approach against cancer, including acute myeloid leukemia (AML). Previously, we reported a cytokine-based culture method for the generation of NK cell products with high cell number and purity. In this system, CD34+ hematopoietic progenitor cells (HPC) were expanded and differentiated into NK cells under stroma-free conditions in the presence of IL-15 and IL-2. We show that combining IL-15 with IL-12 drives the generation of more mature and highly functional NK cells. In particular, replacement of IL-2 by IL-12 enhanced the cytolytic activity and IFNγ production of HPC-NK cells toward cultured and primary AML cells in vitro, and improved antileukemic responses in NOD/SCID-IL2Rγnull (NSG) mice bearing human AML cells. Phenotypically, IL-12 increased the frequency of HPC-NK cells expressing NKG2A and killer immunoglobulin-like receptor (KIR), which were more responsive to target cell stimulation. In addition, NK15/12 cell products demonstrated superior maturation potential, resulting in >70% positivity for CD16 and/or KIR within 2 weeks after infusion into NSG mice. We predict that higher functionality and faster in vivo maturation will favor HPC-NK cell alloreactivity toward malignant cells in patients, making this cytokine combination an attractive strategy to generate clinical HPC-NK cell products for cancer adoptive immunotherapy.
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Affiliation(s)
- Jeannette Cany
- Department of Laboratory Medicine; Laboratory of Hematology; Radboud University Medical Center (Radboudumc); Nijmegen, The Netherlands
| | - Anniek B van der Waart
- Department of Laboratory Medicine; Laboratory of Hematology; Radboud University Medical Center (Radboudumc); Nijmegen, The Netherlands
| | - Jan Spanholtz
- Glycostem Therapeutics; 's-Hertogenbosch , The Netherlands
| | | | - Joop H Jansen
- Department of Laboratory Medicine; Laboratory of Hematology; Radboud University Medical Center (Radboudumc); Nijmegen, The Netherlands
| | - Robbert van der Voort
- Department of Laboratory Medicine; Laboratory of Hematology; Radboud University Medical Center (Radboudumc); Nijmegen, The Netherlands
| | | | - Harry Dolstra
- Department of Laboratory Medicine; Laboratory of Hematology; Radboud University Medical Center (Radboudumc); Nijmegen, The Netherlands
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217
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Grosso D, Gaballa S, Alpdogan O, Carabasi M, Filicko-O’Hara J, Kasner M, Martinez-Outschoorn U, Wagner JL, O'Hara W, Rudolph S, Chervoneva I, Colombe B, Farley PC, Flomenberg P, Pro B, Sharma M, Shi W, Weiss M, Flomenberg N. A Two-Step Approach to Myeloablative Haploidentical Transplantation: Low Nonrelapse Mortality and High Survival Confirmed in Patients with Earlier Stage Disease. Biol Blood Marrow Transplant 2015; 21:646-52. [DOI: 10.1016/j.bbmt.2014.12.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 12/17/2014] [Indexed: 10/24/2022]
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218
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Haploidentical hematopoietic transplantation from KIR ligand-mismatched donors with activating KIRs reduces nonrelapse mortality. Blood 2015; 125:3173-82. [PMID: 25769621 DOI: 10.1182/blood-2014-09-599993] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 03/02/2015] [Indexed: 02/07/2023] Open
Abstract
Because activating killer cell immunoglobulinlike receptors (KIRs) are heterogeneously expressed in the population, we investigated the role of donor activating KIRs in haploidentical hematopoietic transplants for acute leukemia. Transplants were grouped according to presence vs absence of KIR-ligand mismatches in the graft-vs-host direction (ie, of donor-vs-recipient natural killer [NK]-cell alloreactivity). In the absence of donor-vs-recipient NK-cell alloreactivity, donor activating KIRs had no effects on outcomes. In the 69 transplant pairs with donor-vs-recipient NK-cell alloreactivity, transplantation from donors with KIR2DS1 and/or KIR3DS1 was associated with reduced risk of nonrelapse mortality, largely infection related (KIR2DS1 present vs absent: hazard ratio [HR], 0.25; P = .01; KIR3DS1 present vs absent: HR, 0.18; P = .006), and better event-free survival (KIR2DS1 present vs absent: HR, 0.31; P = .011; KIR3DS1 present vs absent: HR, 0.30; P = .008). Transplantation from donors with KIR2DS1 and/or KIR3DS1 was also associated with a 50% reduction in infection rate (P = .003). In vitro analyses showed that KIR2DS1 binding to its HLA-C2 ligand upregulated inflammatory cytokine production by alloreactive NK cells in response to infectious challenges. Because ∼40% of donors able to exert donor-vs-recipient NK-cell alloreactivity carry KIR2DS1 and/or KIR3DS1, searching for them may become a feasible, additional criterion in donor selection.
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219
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Bachanova V. "Uncovering" the recovery of natural killer cells after reduced-intensity conditioning transplantation. Biol Blood Marrow Transplant 2015; 21:383-4. [PMID: 25615609 PMCID: PMC5577011 DOI: 10.1016/j.bbmt.2015.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
Affiliation(s)
- Veronika Bachanova
- Blood and Marrow Transplantation Program, University of Minnesota, Minneapolis, Minnesota.
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220
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Foley B, Felices M, Cichocki F, Cooley S, Verneris MR, Miller JS. The biology of NK cells and their receptors affects clinical outcomes after hematopoietic cell transplantation (HCT). Immunol Rev 2015; 258:45-63. [PMID: 24517425 DOI: 10.1111/imr.12157] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Natural killer (NK) cells were first identified for their capacity to reject bone marrow allografts in lethally irradiated mice without prior sensitization. Subsequently, human NK cells were detected and defined by their non-major histocompatibility complex (MHC)-restricted cytotoxicity toward transformed or virally infected target cells. Karre et al. later proposed 'the missing self hypothesis' to explain the mechanism by which self-tolerant cells could kill targets that had lost self MHC class I. Subsequently, the receptors that recognize MHC class I to mediate tolerance in the host were identified on NK cells. These class I-recognizing receptors contribute to the acquisition of function by a dynamic process known as NK cell education or licensing. In the past, NK cells were assumed to be short lived, but more recently NK cells have been shown to mediate immunologic memory to secondary exposures to cytomegalovirus infection. Because of their ability to lyse tumors with aberrant MHC class I expression and to produce cytokines and chemokines upon activation, NK cells may be primed by many stimuli, including viruses and inflammation, to contribute to a graft-versus-tumor effect. In addition, interactions with other immune cells support the therapeutic potential of NK cells to eradicate tumor and to enhance outcomes after hematopoietic cell transplantation.
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Affiliation(s)
- Bree Foley
- Adult, Oncology and Transplantation, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
| | - Martin Felices
- Adult, Oncology and Transplantation, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
| | - Frank Cichocki
- Adult, Oncology and Transplantation, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
| | - Sarah Cooley
- Adult, Oncology and Transplantation, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
| | - Michael R Verneris
- Pediatric Hematology, Oncology and Transplantation, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
| | - Jeffrey S Miller
- Adult, Oncology and Transplantation, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
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221
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Yoon SR, Kim TD, Choi I. Understanding of molecular mechanisms in natural killer cell therapy. Exp Mol Med 2015; 47:e141. [PMID: 25676064 PMCID: PMC4346487 DOI: 10.1038/emm.2014.114] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/17/2014] [Accepted: 12/02/2014] [Indexed: 01/14/2023] Open
Abstract
Cancer cells and the immune system are closely related and thus influence each other. Although immune cells can suppress cancer cell growth, cancer cells can evade immune cell attack via immune escape mechanisms. Natural killer (NK) cells kill cancer cells by secreting perforins and granzymes. Upon contact with cancer cells, NK cells form immune synapses to deliver the lethal hit. Mature NK cells are differentiated from hematopoietic stem cells in the bone marrow. They move to lymph nodes, where they are activated through interactions with dendritic cells. Interleukin-15 (IL-15) is a key molecule that activates mature NK cells. The adoptive transfer of NK cells to treat incurable cancer is an attractive approach. A certain number of activated NK cells are required for adoptive NK cell therapy. To prepare these NK cells, mature NK cells can be amplified to obtain sufficient numbers of NK cells. Alternatively, NK cells can be differentiated and amplified from hematopoietic stem cells. In addition, the selection of donors is important to achieve maximal efficacy. In this review, we discuss the overall procedures and strategies of NK cell therapy against cancer.
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Affiliation(s)
- Suk Ran Yoon
- 1] Immunotherapy Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea [2] Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Tae-Don Kim
- 1] Immunotherapy Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea [2] Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Inpyo Choi
- 1] Immunotherapy Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea [2] Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
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222
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Saraceni F, Shem-Tov N, Olivieri A, Nagler A. Mobilized peripheral blood grafts include more than hematopoietic stem cells: the immunological perspective. Bone Marrow Transplant 2015; 50:886-91. [PMID: 25665044 DOI: 10.1038/bmt.2014.330] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 12/10/2014] [Accepted: 12/12/2014] [Indexed: 01/20/2023]
Abstract
Although stem cell mobilization has been performed for more than 20 years, little is known about the effects of mobilizing agents on apheresis composition and the impact of graft cell subsets on patients' outcome. With the increasing use of plerixafor and the inclusion of poor mobilizers in autologous transplant procedures, new parameters other than CD34(+) stem cell dose are emerging; plerixafor seems to mobilize more primitive CD34(+)/CD38(-) stem cells compared with G-CSF, but their correlation with stable hematopoietic engraftment is still obscure. Immune recovery is as crucial as hematopoietic reconstitution, and higher T and natural killer cells infused within the graft have been correlated with better outcome in autologous transplant; recent studies showed increased mobilization of immune effectors with plerixafor compared with G-CSF, but further data are needed to clarify the clinical impact of these findings. In the allogeneic setting, much evidence suggests that mobilized T-cell alloreactivity is tempered by G-CSF, probably with the mediation of dendritic cells, even though no clear correlation with GVL and GVHD has been found. Plerixafor is not approved in healthy donors yet; early data suggest it might mobilize a GVHD protective balance of immune effectors, but further studies are needed to define its role in allogeneic transplant.
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Affiliation(s)
- F Saraceni
- 1] Department of Hematology and Bone Marrow Transplantation, Ospedali Riuniti, Ancona, Italy [2] Department of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - N Shem-Tov
- Department of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - A Olivieri
- Department of Hematology and Bone Marrow Transplantation, Ospedali Riuniti, Ancona, Italy
| | - A Nagler
- Department of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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223
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Catalán E, Charni S, Jaime P, Aguiló JI, Enríquez JA, Naval J, Pardo J, Villalba M, Anel A. MHC-I modulation due to changes in tumor cell metabolism regulates tumor sensitivity to CTL and NK cells. Oncoimmunology 2015; 4:e985924. [PMID: 25949869 DOI: 10.4161/2162402x.2014.985924] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/05/2014] [Indexed: 12/19/2022] Open
Abstract
Tumor cells have a tendency to use glucose fermentation to obtain energy instead of mitochondrial oxidative phosphorylation (OXPHOS). We demonstrated that this phenotype correlated with loss of ERK5 expression and with reduced MHC class I expression. Consequently, tumor cells could evade cytotoxic T lymphocyte (CTL)-mediated immune surveillance, but also increase their sensitivity to natural killer (NK) cells. These outcomes were evaluated using two cellular models: leukemic EL4 cells and L929 transformed fibroblasts and their derived ρ° cell lines, which lack mitochondrial DNA. We have also used a L929 cell sub-line that spontaneously lost matrix attachment (L929dt), reminiscent of metastasis generation, that also downregulated MHC-I and ERK5 expression. MHC-I expression is lower in ρ° cells than in the parental cell lines, but they were equally sensitive to CTL. On the contrary, ρ° cells were more sensitive to activated NK cells than parental cells. On the other hand, L929dt cells were resistant to CTL and NK cells, showed reduced viability when forced to perform OXPHOS, and surviving cells increased MHC-I expression and became sensitive to CTL. The present results suggest that when the reduction in MHC-I levels in tumor cells due to glycolytic metabolism is partial, the increase in sensitivity to NK cells seems to predominate. However, when tumor cells completely lose MHC-I expression, the combination of treatments that increase OXPHOS with CTL-mediated immunotherapy could be a promising therapeutic approach.
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Affiliation(s)
- Elena Catalán
- Apoptosis; Immunity & Cancer Group; Dept. Biochemistry and Molecular and Cell Biology; Faculty of Sciences; Campus San Francisco Sq.; University of Zaragoza and Aragón Health Research Institute (IIS Aragón) ; Zaragoza, Spain
| | - Seyma Charni
- INSERM-UM1 U1040; Université de Montpellier 1,UFR Médecine ; Montpellier, France ; Institut de Recherche en Biothérapie (IRB); CHU Montpellier ; Hôpital Saint-Eloi, 80, Av. Augustin Fliche ; Montpellier, France
| | - Paula Jaime
- Immune Effector Cells Group; IIS Aragón; Biomedical Research Centre of Aragón (CIBA)-Nanoscience Institute of Aragon (INA) ; Avda. San Juan Bosco ; Zaragoza, Spain
| | - Juan Ignacio Aguiló
- Apoptosis; Immunity & Cancer Group; Dept. Biochemistry and Molecular and Cell Biology; Faculty of Sciences; Campus San Francisco Sq.; University of Zaragoza and Aragón Health Research Institute (IIS Aragón) ; Zaragoza, Spain
| | - José Antonio Enríquez
- Dept. Biochemistry and Molecular and Cell Biology; University of Zaragoza and Dept. of Cardiovascular Development and Repair; National Center for Cardiovascular Research Carlos III; Melchor Fernandez Almagro ; Madrid, Spain
| | - Javier Naval
- Apoptosis; Immunity & Cancer Group; Dept. Biochemistry and Molecular and Cell Biology; Faculty of Sciences; Campus San Francisco Sq.; University of Zaragoza and Aragón Health Research Institute (IIS Aragón) ; Zaragoza, Spain
| | - Julián Pardo
- Immune Effector Cells Group; IIS Aragón; Biomedical Research Centre of Aragón (CIBA)-Nanoscience Institute of Aragon (INA) ; Avda. San Juan Bosco ; Zaragoza, Spain ; Aragón I+D Foundation (ARAID) ; Avda. San Juan Bosco ; Zaragoza, Spain
| | - Martín Villalba
- INSERM-UM1 U1040; Université de Montpellier 1,UFR Médecine ; Montpellier, France ; Institut de Recherche en Biothérapie (IRB); CHU Montpellier ; Hôpital Saint-Eloi, 80, Av. Augustin Fliche ; Montpellier, France
| | - Alberto Anel
- Apoptosis; Immunity & Cancer Group; Dept. Biochemistry and Molecular and Cell Biology; Faculty of Sciences; Campus San Francisco Sq.; University of Zaragoza and Aragón Health Research Institute (IIS Aragón) ; Zaragoza, Spain
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224
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Peragine N, Torelli GF, Mariglia P, Pauselli S, Vitale A, Guarini A, Foà R. Immunophenotypic and functional characterization of ex vivo expanded natural killer cells for clinical use in acute lymphoblastic leukemia patients. Cancer Immunol Immunother 2015; 64:201-11. [PMID: 25341808 PMCID: PMC11029629 DOI: 10.1007/s00262-014-1614-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 09/17/2014] [Indexed: 01/06/2023]
Abstract
The management of acute lymphoblastic leukemia (ALL) patients has witnessed profound changes in recent years. Nonetheless, most patients tend to relapse, underlining the need for new therapeutic approaches. The anti-leukemic potential of natural killer (NK) cells has over the years raised considerable interest. In this study, we developed an efficient method for the expansion and activation of NK cells isolated from healthy donors and ALL patients for clinical use. NK cell products were derived from peripheral blood mononuclear cells of 35 healthy donors and 4 B-lineage ALL by immunomagnetic CD3 T cell depletion followed by CD56 cell enrichment. Isolated NK cells were expanded and stimulated in serum-free medium supplemented with irradiated autologous feeder cells and autologous plasma in the presence of clinical grade interleukin (IL)-2 and IL-15 for 14 days. Healthy donor NK cells expanded on average 34.9 ± 10.4 fold and were represented, after expansion, by a highly pure population of CD3(-)CD56(+) cells showing a significant upregulation of natural cytotoxicity receptors, activating receptors and maturation markers. These expanded effectors showed cytolytic activity against K562 cells and, most importantly, against primary adult B-lineage ALL blasts. NK cells could be efficiently isolated and expanded-on average 39.5 ± 20.3 fold-also from primary B-lineage ALL samples of patients in complete remission. The expanded NK cells from these patients showed a significantly increased expression of the NKG2D- and DNAM1-activating receptors and were cytotoxic against K562 cells. These data provide the basis for developing new immunotherapeutic strategies for the management of ALL patients.
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Affiliation(s)
- Nadia Peragine
- Hematology, Department of Cellular Biotechnologies and Hematology, “Sapienza” University, Via Benevento 6, 00161 Rome, Italy
| | - Giovanni F. Torelli
- Hematology, Department of Cellular Biotechnologies and Hematology, “Sapienza” University, Via Benevento 6, 00161 Rome, Italy
| | - Paola Mariglia
- Hematology, Department of Cellular Biotechnologies and Hematology, “Sapienza” University, Via Benevento 6, 00161 Rome, Italy
| | - Simona Pauselli
- Hematology, Department of Cellular Biotechnologies and Hematology, “Sapienza” University, Via Benevento 6, 00161 Rome, Italy
| | - Antonella Vitale
- Hematology, Department of Cellular Biotechnologies and Hematology, “Sapienza” University, Via Benevento 6, 00161 Rome, Italy
| | - Anna Guarini
- Hematology, Department of Cellular Biotechnologies and Hematology, “Sapienza” University, Via Benevento 6, 00161 Rome, Italy
| | - Robin Foà
- Hematology, Department of Cellular Biotechnologies and Hematology, “Sapienza” University, Via Benevento 6, 00161 Rome, Italy
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225
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Gorin NC, Labopin M, Piemontese S, Arcese W, Santarone S, Huang H, Meloni G, Ferrara F, Beelen D, Sanz M, Bacigalupo A, Ciceri F, Mailhol A, Nagler A, Mohty M. T-cell-replete haploidentical transplantation versus autologous stem cell transplantation in adult acute leukemia: a matched pair analysis. Haematologica 2015; 100:558-64. [PMID: 25637051 DOI: 10.3324/haematol.2014.111450] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Adult patients with acute leukemia in need of a transplant but without a genoidentical donor are usually considered upfront for transplantation with stem cells from any other allogeneic source, rather than autologous stem cell transplantation. We used data from the European Society for Blood and Marrow Transplantation and performed a matched pair analysis on 188 T-cell-replete haploidentical and 356 autologous transplants done from January 2007 to December 2012, using age, diagnosis, disease status, cytogenetics, and interval from diagnosis to transplant as matching factors. "Haploidentical expert" centers were defined as having reported more than five haploidentical transplants for acute leukemia (median value for the study period). The median follow-up was 28 months. Multivariate analyses, including type of transplant categorized into three classes ("haploidentical regular", "haploidentical expert" and autologous), conditioning intensity (reduced intensity versus myeloablative conditioning) and the random effect taking into account associations related to matching, showed that non-relapse mortality was higher following haploidentical transplants in expert (HR: 4.7; P=0.00004) and regular (HR: 8.98; P<10(-5)) centers. Relapse incidence for haploidentical transplants was lower in expert centers (HR:0.39; P=0.0003) but in regular centers was similar to that for autologous transplants. Leukemia-free survival and overall survival rates were higher following autologous transplantation than haploidentical transplants in regular centers (HR: 1.63; P=0.008 and HR: 2.31; P=0.0002 respectively) but similar to those following haploidentical transplants in expert centers. We conclude that autologous stem cell transplantation should presently be considered as a possible alternative to haploidentical transplantation in regular centers that have not developed a specific expert program.
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Affiliation(s)
- Norbert-Claude Gorin
- APHP, Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France Sorbonne Universités, UPMC University Paris 06, France INSERM UMR-S 938, Paris, France
| | - Myriam Labopin
- APHP, Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France Sorbonne Universités, UPMC University Paris 06, France INSERM UMR-S 938, Paris, France
| | - Simona Piemontese
- APHP, Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France Ospedale San Raffaele s.r.l. Via Olgettina 60, Milan, Italy
| | - William Arcese
- Rome Transplant Network, Tor Vergata University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - Stella Santarone
- Ospedale Civile, Department of Hematology, Fonte Romana 8, Pescara, Italy
| | - He Huang
- First Affiliated Hospital, Zhejiang University, Bone Marrow Transplantation Center, Hangzhou Zhejiang, China
| | | | | | - Dietrich Beelen
- University Hospital, Dept. of Bone Marrow Transplantation, Essen, Germany
| | - Miguel Sanz
- Hospital Universitario La Fe, University of Valencia, Spain
| | | | - Fabio Ciceri
- Ospedale San Raffaele s.r.l. Via Olgettina 60, Milan, Italy
| | - Audrey Mailhol
- APHP, Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France
| | - Arnon Nagler
- Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Mohamad Mohty
- APHP, Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France Sorbonne Universités, UPMC University Paris 06, France INSERM UMR-S 938, Paris, France
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226
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Role of Donor Activating KIR-HLA Ligand-Mediated NK Cell Education Status in Control of Malignancy in Hematopoietic Cell Transplant Recipients. Biol Blood Marrow Transplant 2015; 21:829-39. [PMID: 25617806 DOI: 10.1016/j.bbmt.2015.01.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 01/19/2015] [Indexed: 11/21/2022]
Abstract
Some cancers treated with allogeneic hematopoietic stem cell transplantation (HSCT) are sensitive to natural killer cell (NK) reactivity. NK function depends on activating and inhibitory receptors and is modified by NK education/licensing effect and mediated by coexpression of inhibitory killer-cell immunoglobulin-like receptor (KIR) and its corresponding HLA I ligand. We assessed activating KIR (aKIR)-based HLA I-dependent education capacity in donor NKs in 285 patients with hematological malignancies after HSCT from unrelated donors. We found significantly adverse progression-free survival (PFS) and time to progression (TTP) in patients who received transplant from donors with NKs educated by C1:KIR2DS2/3, C2:KIR2DS1, or Bw4:KIR3DS1 pairs (for PFS: hazard ratio [HR], 1.70; P = .0020, Pcorr = .0039; HR, 1.54; P = .020, Pcorr = .039; HR, 1.51; P = .020, Pcorr = .040; and for TTP: HR, 1.82; P = .049, Pcorr = .096; HR, 1.72; P = .096, Pcorr = .18; and HR, 1.65; P = .11, Pcorr = .20, respectively). Reduced PFS and TTP were significantly dependent on the number of aKIR-based education systems in donors (HR, 1.36; P = .00031, Pcorr = .00062; and HR, 1.43; P = .019, Pcorr = .038). Furthermore, the PFS and TTP were strongly adverse in patients with missing HLA ligand cognate with educating aKIR-HLA pair in donor (HR, 3.25; P = .00022, Pcorr = .00045; and HR, 3.82; P = .027, Pcorr = .054). Together, these data suggest important qualitative and quantitative role of donor NK education via aKIR-cognate HLA ligand pairs in the outcome of HSCT. Avoiding the selection of transplant donors with high numbers of aKIR-HLA-based education systems, especially for recipients with missing cognate ligand, is advisable.
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227
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Gregoire-Gauthier J, Fontaine F, Benchimol L, Nicoletti S, Selleri S, Dieng MM, Haddad E. Role of Natural Killer Cells in Intravenous Immunoglobulin-Induced Graft-versus-Host Disease Inhibition in NOD/LtSz-scidIL2rg(-/-) (NSG) Mice. Biol Blood Marrow Transplant 2015; 21:821-8. [PMID: 25596424 DOI: 10.1016/j.bbmt.2015.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 01/08/2015] [Indexed: 01/07/2023]
Abstract
Although clinical studies have yet to demonstrate clearly the use of intravenous immunoglobulin (IVIG) for prevention of graft-versus-host disease (GVHD), their effective use in a xenogeneic mouse model has been demonstrated. We aimed to determine the mechanism of action by which IVIG contributes to GVHD prevention in a xenogeneic mouse model. NOD/LtSz-scidIL2rg(-/-) (NSG) mice were used for our xenogeneic mouse model of GVHD. Sublethally irradiated NSG mice were injected with human peripheral blood mononuclear cells (huPBMCs) and treated weekly with PBS or 50 mg IVIG. Incidence of GVHD and survival were noted, along with analysis of cell subsets proliferation in the peripheral blood. Weekly IVIG treatment resulted in a robust and consistent proliferation of human natural killer cells that were activated, as demonstrated by their cytotoxicity against K562 target cells. IVIG treatment did not inhibit GVHD when huPBMCs were depleted in natural killer (NK) cells, strongly suggesting that this NK cell expansion was required for the IVIG-mediated prevention of GVHD in our mouse model. Moreover, inhibition of T cell activation by either cyclosporine A (CsA) or monoclonal antihuman CD3 antibodies abolished the IVIG-induced NK cell expansion. In conclusion, IVIG treatment induces NK cell proliferation, which is essential for IVIG-mediated protection of GVHD in our mouse model. Furthermore, activated T cells are mandatory for effective IVIG-induced NK cell proliferation. These results shed light on a new mechanism of action of IVIG and could explain why the efficacy of IVIG in preventing GVHD in a clinical setting, where patients receive CsA, has never been undoubtedly demonstrated.
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Affiliation(s)
- Joëlle Gregoire-Gauthier
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, Quebec, Canada
| | | | - Lionel Benchimol
- Department of Health Biochemistry, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Simon Nicoletti
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Université Paris Sud, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Silvia Selleri
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, Quebec, Canada
| | | | - Elie Haddad
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada; Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, Quebec, Canada.
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228
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Sánchez-Martínez D, Azaceta G, Muntasell A, Aguiló N, Núñez D, Gálvez EM, Naval J, Anel A, Palomera L, Vilches C, Marzo I, Villalba M, Pardo J. Human NK cells activated by EBV + lymphoblastoid cells overcome anti-apoptotic mechanisms of drug resistance in haematological cancer cells. Oncoimmunology 2015; 4:e991613. [PMID: 25949911 DOI: 10.4161/2162402x.2014.991613] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/21/2014] [Indexed: 01/01/2023] Open
Abstract
Natural killer (NK) cells recognize and eliminate transformed or infected cells that have downregulated MHC class-I and express specific activating ligands. Recent evidence indicates that allogeneic NK cells are useful to eliminate haematological cancer cells independently of MHC-I expression. However, it is unclear if transformed cells expressing mutations that confer anti-apoptotic properties and chemoresistance will be susceptible to NK cells. Allogeneic primary human NK cells were activated using different protocols and prospectively tested for their ability to eliminate diverse mutant haematological and apoptotic-resistant cancer cell lines as well as patient-derived B-cell chronic lymphocytic leukemia cells with chemotherapy multiresistance. Here, we show that human NK cells from healthy donors activated in vitro with Epstein Barr virus positive (EBV+)-lymphoblastoid cells display an enhanced cytotoxic and proliferative potential in comparison to other protocols of activation such a K562 cells plus interleukin (IL)2. This enhancement enables them to kill more efficiently a variety of haematological cancer cell lines, including a panel of transfectants that mimic natural mutations leading to oncogenic transformation and chemoresistance (e.g., overexpression of Bcl-2, Bcl-XL and Mcl-1 or downregulation of p53, Bak/Bax or caspase activity). The effect was also observed against blasts from B-cell chronic lymphocytic leukemia patients showing multi-resistance to chemotherapy. Our findings demonstrate that particular in vitro activated NK cells may overcome anti-apoptotic mechanisms and oncogenic alterations frequently occurring in transformed cells, pointing toward the use of EBV+-lymphoblastoid cells as a desirable strategy to activate NK cells in vitro for the purpose of treating haematological neoplasia with poor prognosis.
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Key Words
- B-CLL, B cell chronic lymphocytic leukemia
- B lymphoblastoid cell line
- EBV, Epstein-Barr virus
- IAP, inhibitor of apoptosis
- KIR, killer inhibitory receptor
- LCL, lymphoblastoid B cell line
- NK cells
- NK, natural killer
- NKR, NK cell receptor
- PBL, peripheral blood lymphocyte
- PBMC, peripheral blood mononuclear cell
- Tc, cytotoxic T
- apoptosis
- haematological neoplasia
- multidrug acquired resistance
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Affiliation(s)
- Diego Sánchez-Martínez
- Immune Effector Cells Group (ICE); Aragón Health Research Institute (IIS Aragón); Edificio CIBA; Biomedical Research Center of Aragón (CIBA) ; Zaragoza, Spain ; Cell Immunity in Inflammation; Infection and Cancer Group; Department of Biochemistry and Molecular and Cell Biology; University of Zaragoza ; Zaragoza, Spain
| | - Gemma Azaceta
- Servicio de Hematología; Hospital Clínico Universitario; Instituto Aragonés de Ciencias de la Salud (IACS); Zaragoza, Spain
| | - Aura Muntasell
- Immunity and infection Lab; IMIM (Hospital del Mar Medical Research Institute) ; Barcelona, Spain
| | - Nacho Aguiló
- Apoptosis; Cancer and Immunity Group; Department of Biochemistry and Molecular and Cellular Biology; University of Zaragoza ; Zaragoza, Spain
| | - David Núñez
- Immune Effector Cells Group (ICE); Aragón Health Research Institute (IIS Aragón); Edificio CIBA; Biomedical Research Center of Aragón (CIBA) ; Zaragoza, Spain ; Cell Immunity in Inflammation; Infection and Cancer Group; Department of Biochemistry and Molecular and Cell Biology; University of Zaragoza ; Zaragoza, Spain
| | - Eva M Gálvez
- Immune Effector Cells Group (ICE); Aragón Health Research Institute (IIS Aragón); Edificio CIBA; Biomedical Research Center of Aragón (CIBA) ; Zaragoza, Spain ; Instituto de Carboquímica ICB-CSIC ; Zaragoza, Spain
| | - Javier Naval
- Immune Effector Cells Group (ICE); Aragón Health Research Institute (IIS Aragón); Edificio CIBA; Biomedical Research Center of Aragón (CIBA) ; Zaragoza, Spain ; Apoptosis; Cancer and Immunity Group; Department of Biochemistry and Molecular and Cellular Biology; University of Zaragoza ; Zaragoza, Spain
| | - Alberto Anel
- Immune Effector Cells Group (ICE); Aragón Health Research Institute (IIS Aragón); Edificio CIBA; Biomedical Research Center of Aragón (CIBA) ; Zaragoza, Spain ; Apoptosis; Cancer and Immunity Group; Department of Biochemistry and Molecular and Cellular Biology; University of Zaragoza ; Zaragoza, Spain
| | - Luis Palomera
- Servicio de Hematología; Hospital Clínico Universitario; Instituto Aragonés de Ciencias de la Salud (IACS); Zaragoza, Spain
| | - Carlos Vilches
- Immunogenetics & HLA; Instituto de Investigación Sanitaria Puerta de Hierro ; Majadahonda, Spain
| | - Isabel Marzo
- Immune Effector Cells Group (ICE); Aragón Health Research Institute (IIS Aragón); Edificio CIBA; Biomedical Research Center of Aragón (CIBA) ; Zaragoza, Spain ; Apoptosis; Cancer and Immunity Group; Department of Biochemistry and Molecular and Cellular Biology; University of Zaragoza ; Zaragoza, Spain
| | - Martín Villalba
- INSERM, U1040; Université de Montpellier 1; UFR Medecine; Montpellier , France ; Institut de Regenerative Medicine et Biothérapie (IRMB); CHU Montpellier ; Montpellier, France
| | - Julián Pardo
- Immune Effector Cells Group (ICE); Aragón Health Research Institute (IIS Aragón); Edificio CIBA; Biomedical Research Center of Aragón (CIBA) ; Zaragoza, Spain ; Cell Immunity in Inflammation; Infection and Cancer Group; Department of Biochemistry and Molecular and Cell Biology; University of Zaragoza ; Zaragoza, Spain ; Aragón I+D Foundation (ARAID); Government of Aragon , Zaragoza, Spain ; Nanoscience Institute of Aragon (INA); University of Zaragoza , Zaragoza, Spain
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229
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Gao L, Zhang X. Haploidentical hematopoietic transplantation without T-cell depletion: current status and future perspectives. Stem Cell Investig 2015; 2:20. [PMID: 27358888 DOI: 10.3978/j.issn.2306-9759.2015.10.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 10/27/2015] [Indexed: 01/14/2023]
Abstract
Human leukocyte antigen (HLA)-haploidentical hematopoietic stem cell transplantation (HLA-haplo HSCT) without T-cell depletion has tremendously progressed over the past 20 years and has become a feasible treatment option for leukemia patients without an HLA-identical sibling donor. Advances in conditioning regimens, graft manipulation, and pharmacological graft-versus-host disease (GVHD) prophylaxis have reduced the risk of fatal graft failure and severe GVHD, two of the most serious complications of traversing the HLA barrier. According to clinical observations, killer immunoglobulin-like receptor (KIR) mismatch and donor-specific anti-HLA (DSA) antibodies-negative status play potential roles in reducing the risk of GVHD and graft failure following HLA-haploidentical SCT. New strategies to improve transplant outcomes include donor lymphocyte, NK cell and selected T-cell subset infusion, mesenchymal stem cell (MSC) co-transplantation and interleukin-2 (IL-2) application. Future challenges remain in improving post-transplant immune reconstitution and finding the best approach to reduce the incidence and severity of GVHD while simultaneously preserving the graft-versus leukemia effect to prevent the recurrence of underlying malignancy.
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Affiliation(s)
- Lei Gao
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing 40037, China
| | - Xi Zhang
- Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing 40037, China
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230
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Chatterjee D, Marquardt N, Tufa DM, Hatlapatka T, Hass R, Kasper C, von Kaisenberg C, Schmidt RE, Jacobs R. Human Umbilical Cord-Derived Mesenchymal Stem Cells Utilize Activin-A to Suppress Interferon-γ Production by Natural Killer Cells. Front Immunol 2014; 5:662. [PMID: 25584044 PMCID: PMC4278046 DOI: 10.3389/fimmu.2014.00662] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/09/2014] [Indexed: 12/12/2022] Open
Abstract
Following allogeneic hematopoietic stem cell transplantation (HSCT), interferon (IFN)-γ levels in the recipient's body can strongly influence the clinical outcome. Human umbilical cord-derived mesenchymal stem cells (UC-MSCs) are lucrative as biological tolerance-inducers in HSCT settings. Hence, we studied the molecular mechanism of how UC-MSCs influence natural killer (NK) cell-mediated IFN-γ production. Allogeneic NK cells were cultured in direct contact with UC-MSCs or cell-free supernatants from mesenchymal stem cell (MSC) cultures (MSC-conditioned media). We found that soluble factors secreted by UC-MSCs strongly suppressed interleukin (IL)-12/IL-18-induced IFN-γ production by NK cells by reducing phosphorylation of STAT4, NF-κB, as well as T-bet activity. UC-MSCs secreted considerable amounts of activin-A, which could suppress IFN-γ production by NK cells. Neutralization of activin-A in MSC-conditioned media significantly abrogated their suppressive abilities. Till date, multiple groups have reported that prostaglandin (PG)-E2 produced by MSCs can suppress NK cell functions. Indeed, we found that inhibition of PGE2 production by MSCs could also significantly restore IFN-γ production. However, the effects of activin-A and PGE2 were not cumulative. To the best of our knowledge, we are first to report the role of activin-A in MSC-mediated suppression of IFN-γ production by NK cells.
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Affiliation(s)
- Debanjana Chatterjee
- Department of Clinical Immunology and Rheumatology, Hannover Medical School , Hannover , Germany
| | - Nicole Marquardt
- Department of Clinical Immunology and Rheumatology, Hannover Medical School , Hannover , Germany
| | - Dejene Milkessa Tufa
- Department of Clinical Immunology and Rheumatology, Hannover Medical School , Hannover , Germany
| | - Tim Hatlapatka
- Institute of Technical Chemistry, Leibniz University of Hannover , Hannover , Germany
| | - Ralf Hass
- Laboratory of Biochemistry and Tumor Biology, Clinic of Obstetrics and Gynecology, Hannover Medical School , Hannover , Germany
| | - Cornelia Kasper
- Institute of Technical Chemistry, Leibniz University of Hannover , Hannover , Germany ; Department of Biotechnology, University of Natural Resources and Life Science , Vienna , Austria
| | - Constantin von Kaisenberg
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School , Hannover , Germany
| | - Reinhold Ernst Schmidt
- Department of Clinical Immunology and Rheumatology, Hannover Medical School , Hannover , Germany
| | - Roland Jacobs
- Department of Clinical Immunology and Rheumatology, Hannover Medical School , Hannover , Germany
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231
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Willems L, Waer M, Billiau AD. The graft-versus-neuroblastoma effect of allogeneic hematopoietic stem cell transplantation, a review of clinical and experimental evidence and a perspective on mechanisms. Pediatr Blood Cancer 2014; 61:2151-7. [PMID: 25156335 DOI: 10.1002/pbc.25169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 06/11/2014] [Indexed: 01/17/2023]
Abstract
Despite aggressive treatment, patients with high-risk neuroblastoma face high relapse rates and bleak prognoses. Increasing evidence that neuroblastoma cells are or can become immunogenic has stimulated research into novel therapies based on triggering or enhancing tumor immunity. Here we review clinical and experimental studies on this subject, the underlying immune mechanisms and perspectives for clinical application. Allogeneic hematopoietic stem cell transplantation has proven to be of substantial benefit in the treatment of certain leukemias through the generation of a graft-versus-leukemia-effect and has become of interest as a possible treatment for patients with solid tumors, including neuroblastoma.
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Affiliation(s)
- Leen Willems
- Laboratory of Experimental Transplantation, KULeuven, Leuven, Belgium
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232
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Acute GVHD in patients receiving IL-15/4-1BBL activated NK cells following T-cell-depleted stem cell transplantation. Blood 2014; 125:784-92. [PMID: 25452614 DOI: 10.1182/blood-2014-07-592881] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Natural killer (NK) cells can enhance engraftment and mediate graft-versus-leukemia following allogeneic hematopoietic stem cell transplantation (HSCT), but the potency of graft-versus-leukemia mediated by naturally reconstituting NK cells following HSCT is limited. Preclinical studies demonstrate that activation of NK cells using interleukin-15 (IL-15) plus 4-1BBL upregulates activating receptor expression and augments killing capacity. In an effort to amplify the beneficial effects of NK cells post-HSCT, we conducted a first-in-human trial of adoptive transfer of donor-derived IL-15/4-1BBL-activated NK cells (aNK-DLI) following HLA-matched, T-cell-depleted (1-2 × 10(4) T cells/kg) nonmyeloablative peripheral blood stem cell transplantation in children and young adults with ultra-high-risk solid tumors. aNK-DLI were CD3(+)-depleted, CD56(+)-selected lymphocytes, cultured for 9 to 11 days with recombinant human IL-15 plus 4-1BBL(+)IL-15Rα(+) artificial antigen-presenting cells. aNK-DLI demonstrated potent killing capacity and displayed high levels of activating receptor expression. Five of 9 transplant recipients experienced acute graft-versus-host disease (GVHD) following aNK-DLI, with grade 4 GVHD observed in 3 subjects. GVHD was more common in matched unrelated donor vs matched sibling donor recipients and was associated with higher donor CD3 chimerism. Given that the T-cell dose was below the threshold required for GVHD in this setting, we conclude that aNK-DLI contributed to the acute GVHD observed, likely by augmenting underlying T-cell alloreactivity. This trial was registered at www.clinicaltrials.gov as #NCT01287104.
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233
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Nabekura T, Lanier LL. Antigen-specific expansion and differentiation of natural killer cells by alloantigen stimulation. ACTA ACUST UNITED AC 2014; 211:2455-65. [PMID: 25366966 PMCID: PMC4235640 DOI: 10.1084/jem.20140798] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Nabekura and Lanier provide evidence that alloantigen stimulation of mouse NK cells promotes the in vivo expansion and generation of memory-like NK cells. NK cells expressing the activating Ly49D receptor preferentially expand and differentiate when challenged with allogeneic cells in an inflammatory environment, but this can be suppressed if NK cells also express the inhibitory Ly49A receptor which recognizes the same ligand. Recall responses were driven by expression of activating Ly49 receptors and regulated by inhibitory MHC I receptors. Natural killer (NK) cells provide important host defense against microbial pathogens and can generate a population of long-lived memory NK cells after infection or immunization. Here, we addressed whether NK cells can expand and differentiate after alloantigen stimulation, which may be important in hematopoietic stem cell and solid tissue transplantation. A subset of NK cell in C57BL/6 mice expresses the activating Ly49D receptor that is specific for H-2Dd. These Ly49D+ NK cells can preferentially expand and differentiate when challenged with allogeneic H-2Dd cells in the context of an inflammatory environment. H-2Dd is also recognized by the inhibitory Ly49A receptor, which, when coexpressed on Ly49D+ NK cells, suppresses the expansion of Ly49D+ NK cells. Specificity of the secondary response of alloantigen-primed NK cells was defined by the expression of activating Ly49 receptors and regulated by the inhibitory receptors for MHC class I. Thus, the summation of signals through a repertoire of Ly49 receptors controls the adaptive immune features of NK cells responding to allogeneic cells.
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Affiliation(s)
- Tsukasa Nabekura
- Department of Microbiology and Immunology and the Cancer Research Institute, University of California, San Francisco, San Francisco, CA 94143 Department of Microbiology and Immunology and the Cancer Research Institute, University of California, San Francisco, San Francisco, CA 94143 Life Science Center, Tsukuba Advanced Research Alliance, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Lewis L Lanier
- Department of Microbiology and Immunology and the Cancer Research Institute, University of California, San Francisco, San Francisco, CA 94143 Department of Microbiology and Immunology and the Cancer Research Institute, University of California, San Francisco, San Francisco, CA 94143
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234
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Eapen M, O'Donnell P, Brunstein CG, Wu J, Barowski K, Mendizabal A, Fuchs EJ. Mismatched related and unrelated donors for allogeneic hematopoietic cell transplantation for adults with hematologic malignancies. Biol Blood Marrow Transplant 2014; 20:1485-92. [PMID: 24862638 PMCID: PMC4163123 DOI: 10.1016/j.bbmt.2014.05.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 01/10/2023]
Abstract
Two parallel phase II trials in adults with hematologic malignancies demonstrated comparable survival after reduced-intensity conditioning and transplantation of either 2 HLA-mismatched umbilical cord blood (UCB) units or bone marrow from HLA-haploidentical relatives. Donor choice is often subject to physician practice and institutional preference. Despite clear preliminary evidence of equipoise between HLA-haploidentical related donor and double unrelated donor UCB transplantation, the actual prospect of being randomized between these 2 very different donor sources is daunting to patients and their treating physicians alike. Under these circumstances, it is challenging to conduct a phase III randomized trial in which patients are assigned to the UCB or haploidentical bone marrow arms. Therefore, we aimed to provide an evidence-based review and recommendations for selecting donors for adults without an HLA-matched sibling or an HLA-matched adult unrelated donor.
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Affiliation(s)
- Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Paul O'Donnell
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Claudio G Brunstein
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Juan Wu
- EMMES Corporation, Rockville, Maryland
| | | | | | - Ephraim J Fuchs
- Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, Maryland
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235
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Nowak J, Kościńska K, Mika-Witkowska R, Rogatko-Koroś M, Mizia S, Jaskuła E, Polak M, Mordak-Domagała M, Lange J, Gronkowska A, Jędrzejczak WW, Kyrcz-Krzemień S, Markiewicz M, Dzierżak-Mietła M, Tomaszewska A, Nasiłowska-Adamska B, Szczepiński A, Hałaburda K, Hellmann A, Komarnicki M, Gil L, Czyż A, Wachowiak J, Barańska M, Kowalczyk J, Drabko K, Goździk J, Wysoczańska B, Bogunia-Kubik K, Graczyk-Pol E, Witkowska A, Marosz-Rudnicka A, Nestorowicz K, Dziopa J, Szlendak U, Warzocha K, Lange AA. Donor NK cell licensing in control of malignancy in hematopoietic stem cell transplant recipients. Am J Hematol 2014; 89:E176-83. [PMID: 25044365 DOI: 10.1002/ajh.23802] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/07/2014] [Indexed: 12/26/2022]
Abstract
Among cancers treated with allogeneic hematopoietic stem-cell transplantation (HSCT), some are sensitive to natural killer (NK) cell reactivity, described as the "missing self" recognition effect. However, this model disregarded the NK cell licensing effect, which highly increases the NK cell reactivity against tumor and is dependent on the coexpression of inhibitory killer cell immunoglobulin-like receptor (iKIR) and its corresponding HLA Class I ligand. We assessed clinical data, HLA and donor iKIR genotyping in 283 patients with myelo- and lymphoproliferative malignancies who underwent HSCT from unrelated donors. We found dramatically reduced overall survival (OS), progression free survival (PFS), and time to progression (TTP) among patients with malignant diseases with the lack of HLA ligand cognate with this iKIR involved in NK cell licensing in corresponding donor (events 83.3% vs. 39.8%, P = 0.0010; 91.6% vs. 47.7%, P = 0.00010; and 30.0% vs. 17.3%, P = 0.013, for OS, PFS, and TTP, respectively). The extremely adverse PFS have withstand the correction when patient group was restricted to HLA mismatched donor-recipient pairs. The incidence of aGvHD was comparable in two groups of patients. In malignant patients after HSCT the missing HLA ligand for iKIR involved in NK cell licensing in corresponding donor ("missing licensing proof") induced extremely adverse survival of the patients due to the progression of malignancy and not to the aGvHD. Avoiding the selection of HSCT donors with the "missing licensing proof" in the malignant patient is strongly advisable.
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Affiliation(s)
- Jacek Nowak
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Katarzyna Kościńska
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry; Wroclaw
| | - Renata Mika-Witkowska
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Marta Rogatko-Koroś
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Sylwia Mizia
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry; Wroclaw
| | - Emilia Jaskuła
- Department of Clinical Immunology; L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences; Wroclaw
| | - Małgorzata Polak
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry; Wroclaw
| | - Monika Mordak-Domagała
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry; Wroclaw
| | - Janusz Lange
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry; Wroclaw
| | - Anna Gronkowska
- Department of Hematology, Oncology and Internal Medicine; Medical University of Warsaw; Warsaw
| | | | | | - Mirosław Markiewicz
- Department of Hematology and Bone Marrow Transplantation; Silesian Medical University; Katowice
| | - Monika Dzierżak-Mietła
- Department of Hematology and Bone Marrow Transplantation; Silesian Medical University; Katowice
| | - Agnieszka Tomaszewska
- Department of Hematopoietic Stem Cell Transplantation; Institute of Hematology and Transfusion Medicine, Warsaw
| | - Barbara Nasiłowska-Adamska
- Department of Hematopoietic Stem Cell Transplantation; Institute of Hematology and Transfusion Medicine, Warsaw
| | - Andrzej Szczepiński
- Department of Hematopoietic Stem Cell Transplantation; Institute of Hematology and Transfusion Medicine, Warsaw
| | - Kazimierz Hałaburda
- Department of Hematopoietic Stem Cell Transplantation; Institute of Hematology and Transfusion Medicine, Warsaw
| | - Andrzej Hellmann
- Department of Hematology and Transplantology; Medical University of Gdansk
| | - Mieczysław Komarnicki
- Chair and Department of Hematology and Proliferative Diseases of Hematopoiesis; Poznan University of Medical Sciences; Poznan
| | - Lidia Gil
- Chair and Department of Hematology and Proliferative Diseases of Hematopoiesis; Poznan University of Medical Sciences; Poznan
| | - Anna Czyż
- Chair and Department of Hematology and Proliferative Diseases of Hematopoiesis; Poznan University of Medical Sciences; Poznan
| | - Jacek Wachowiak
- Department of Pediatrics Oncology, Hematology and Transplantology; Poznan University of Medical Sciences; Poznan
| | - Małgorzata Barańska
- Department of Pediatrics Oncology, Hematology and Transplantology; Poznan University of Medical Sciences; Poznan
| | - Jerzy Kowalczyk
- Department of Pediatric Hematology, Oncology and Transplantology; Medical University; Lublin
| | - Katarzyna Drabko
- Department of Pediatric Hematology, Oncology and Transplantology; Medical University; Lublin
| | - Jolanta Goździk
- Chair of Clinical Immunology and Transplantation Polish-American Institute of Pediatrics, Jagiellonian University Medical College; Department of Transplantation Children's University Hospital; Krakow
| | - Barbara Wysoczańska
- Department of Clinical Immunology; L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences; Wroclaw
| | - Katarzyna Bogunia-Kubik
- Department of Clinical Immunology; L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences; Wroclaw
| | - Elżbieta Graczyk-Pol
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Agnieszka Witkowska
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Anna Marosz-Rudnicka
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Klaudia Nestorowicz
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Joanna Dziopa
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Urszula Szlendak
- Department of Immunogenetics, Institute of Hematology and Transfusion Medicine; Warsaw
| | - Krzysztof Warzocha
- Department of Hematology; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - and Andrzej Lange
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry; Wroclaw
- Department of Clinical Immunology; L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences; Wroclaw
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Eguizabal C, Zenarruzabeitia O, Monge J, Santos S, Vesga MA, Maruri N, Arrieta A, Riñón M, Tamayo-Orbegozo E, Amo L, Larrucea S, Borrego F. Natural killer cells for cancer immunotherapy: pluripotent stem cells-derived NK cells as an immunotherapeutic perspective. Front Immunol 2014; 5:439. [PMID: 25309538 PMCID: PMC4164009 DOI: 10.3389/fimmu.2014.00439] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 08/29/2014] [Indexed: 12/12/2022] Open
Abstract
Natural killer (NK) cells play an essential role in the fight against tumor development. Over the last years, the progress made in the NK-cell biology field and in deciphering how NK-cell function is regulated, is driving efforts to utilize NK-cell-based immunotherapy as a promising approach for the treatment of malignant diseases. Therapies involving NK cells may be accomplished by activating and expanding endogenous NK cells by means of cytokine treatment or by transferring exogenous cells by adoptive cell therapy and/or by hematopoietic stem cell transplantation. NK cells that are suitable for adoptive cell therapy can be derived from different sources, including ex vivo expansion of autologous NK cells, unstimulated or expanded allogeneic NK cells from peripheral blood, derived from CD34+ hematopoietic progenitors from peripheral blood and umbilical cord blood, and NK-cell lines. Besides, genetically modified NK cells expressing chimeric antigen receptors or cytokines genes may also have a relevant future as therapeutic tools. Recently, it has been described the derivation of large numbers of functional and mature NK cells from pluripotent stem cells, both embryonic stem cells and induced pluripotent stem cells, which adds another tool to the expanding NK-cell-based cancer immunotherapy arsenal.
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Affiliation(s)
| | | | - Jorge Monge
- Basque Center for Transfusion and Human Tissues , Galdakao , Spain
| | - Silvia Santos
- Basque Center for Transfusion and Human Tissues , Galdakao , Spain
| | | | - Natalia Maruri
- Regulation of the Immune System Group, BioCruces Health Research Institute , Barakaldo , Spain
| | - Arantza Arrieta
- Regulation of the Immune System Group, BioCruces Health Research Institute , Barakaldo , Spain
| | - Marta Riñón
- Regulation of the Immune System Group, BioCruces Health Research Institute , Barakaldo , Spain
| | | | - Laura Amo
- Regulation of the Immune System Group, BioCruces Health Research Institute , Barakaldo , Spain
| | - Susana Larrucea
- Regulation of the Immune System Group, BioCruces Health Research Institute , Barakaldo , Spain
| | - Francisco Borrego
- Immunopathology Group, BioCruces Health Research Institute , Barakaldo , Spain ; Ikerbasque, Basque Foundation for Science , Bilbao , Spain
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237
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Krakow EF, Bergeron J, Lachance S, Roy DC, Delisle JS. Harnessing the power of alloreactivity without triggering graft-versus-host disease: how non-engrafting alloreactive cellular therapy might change the landscape of acute myeloid leukemia treatment. Blood Rev 2014; 28:249-61. [PMID: 25228333 DOI: 10.1016/j.blre.2014.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 06/13/2014] [Accepted: 08/19/2014] [Indexed: 12/20/2022]
Abstract
Human leukocyte antigen-mismatched leukocyte infusions outside of the context of transplantation are a promising strategy for acute myeloid leukemia. Recent studies using such non-engrafting alloreactive cellular therapy (NEACT) revealed that survival of elderly patients increased from 10% to 39% when NEACT was given following chemotherapy, and that durable complete remissions were achieved in about a third of patients with relapsed or chemorefractory disease. We review the clinical reports of different NEACT approaches to date and describe how although T-cell and NK alloreactivity could generate immediate anti-leukemic effects, long-term disease control may be achieved by stimulating recipient-derived T-cell responses against tumor-associated antigens. Other variables likely impacting NEACT such as the release of pro-inflammatory cytokines from donor-host bidirectional alloreactivity and the choice of chemotherapeutics as well as future avenues for improving NEACT, such as optimizing the cell dose and potential synergies with adjuvant pharmacologic immune checkpoint blockade, are discussed.
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Affiliation(s)
- Elizabeth F Krakow
- Department of Medicine, Division of Hematology and Oncology, Hôpital Maisonneuve-Rosemont Research Center, Université de Montréal, 5415 de l'Assomption, Montreal, Quebec, H1T 2M4, Canada.
| | - Julie Bergeron
- Department of Medicine, Division of Hematology and Oncology, Hôpital Maisonneuve-Rosemont Research Center, Université de Montréal, 5415 de l'Assomption, Montreal, Quebec, H1T 2M4, Canada.
| | - Silvy Lachance
- Department of Medicine, Division of Hematology and Oncology, Hôpital Maisonneuve-Rosemont Research Center, Université de Montréal, 5415 de l'Assomption, Montreal, Quebec, H1T 2M4, Canada.
| | - Denis-Claude Roy
- Department of Medicine, Division of Hematology and Oncology, Hôpital Maisonneuve-Rosemont Research Center, Université de Montréal, 5415 de l'Assomption, Montreal, Quebec, H1T 2M4, Canada.
| | - Jean-Sébastien Delisle
- Department of Medicine, Division of Hematology and Oncology, Hôpital Maisonneuve-Rosemont Research Center, Université de Montréal, 5415 de l'Assomption, Montreal, Quebec, H1T 2M4, Canada.
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238
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Patriarca F, Luznik L, Medeot M, Zecca M, Bacigalupo A, Di Bartolomeo P, Arcese W, Corradini P, Ciceri F, Vago L, Kanakry CG, Fleischhauer K, Martelli MF, Bosi A, Rambaldi A, Cesaro S, Russo D, Fanin R. Experts' considerations on HLA-haploidentical stem cell transplantation. Eur J Haematol 2014; 93:187-97. [PMID: 24660868 DOI: 10.1111/ejh.12322] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2014] [Indexed: 12/15/2022]
Abstract
Recently, novel strategies to control graft-versus-host disease and facilitate engraftment have allowed an increasing number of human leukocyte antigen (HLA)-haploidentical hematopoietic stem cell transplantation (haploHSCT) to be performed. A meeting was convened to review the biological rationale and the clinical results of various T-cell-depleted (TCD) and T-cell-replete (TCR) HLA-haploidentical 'transplant platforms'. The objective of the meeting was to promote discussion and consent among leading researchers in the field on three main crucial issues for haploHSCT: (i) eligibility criteria, (ii) choice of the most suitable donor, and (iii) choice of the most appropriate transplant platform. The experts in attendance agreed that a patient who is eligible for an allogeneic transplant and lacks an HLA-identical sibling or an HLA-matched unrelated donor should be considered for an alternative donor transplant. Together with the experience of the individual center, the most important decision criteria in choosing an alternative donor source should be the rapidity of transplantation so as to avoid disease relapse/progression. The choice of the mismatched donor should be driven by younger age, ABO blood group compatibility, and Cytomegalovirus status. If a TCD transplant is planned, NK-alloreactive donors and/or the mother should be preferred. Prospective comparative studies are needed to establish the relative efficacy of different transplant platforms. However, expertise in stem cell manipulation and in adoptive immunotherapy is essential if a TCD transplant platform is chosen.
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Affiliation(s)
- Francesca Patriarca
- Department of Hematology, Stem Cell Transplant Unit, DISM, University Hospital, Udine, Italy
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239
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Impola U, Turpeinen H, Alakulppi N, Linjama T, Volin L, Niittyvuopio R, Partanen J, Koskela S. Donor Haplotype B of NK KIR Receptor Reduces the Relapse Risk in HLA-Identical Sibling Hematopoietic Stem Cell Transplantation of AML Patients. Front Immunol 2014; 5:405. [PMID: 25202311 PMCID: PMC4142321 DOI: 10.3389/fimmu.2014.00405] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/07/2014] [Indexed: 11/17/2022] Open
Abstract
Successful allogeneic hematopoietic stem cell transplantation (HSCT) depends not only on good HLA match but also on T-cell mediated graft-versus-leukemia (GvL) effect. Natural killer (NK) cells are able to kill malignant cells by receiving activation signal from the killer-cell immunoglobulin-like receptors (KIR) recognizing HLA molecules on a cancer cell. It has been recently reported that the risk of relapse in allogeneic hematopoietic stem cell transplantation (HSCT) is reduced in acute myeloid leukemia (AML) patients whose donors have several activating KIR genes or KIR B-motifs in unrelated donor setting, obviously due to enhanced GvL effect by NK cells. We studied the effect on relapse rate of donor KIR haplotypes in the HLA-identical adult sibling HSCT, done in a single center, in Helsinki University Central Hospital, Helsinki, Finland. Altogether, 134 patients with 6 different diagnoses were identified. Their donors were KIR genotyped using the Luminex and the SSP techniques. The clinical endpoint, that is, occurrence of relapse, was compared with the presence or absence of single KIR genes. Also, time from transplantation to relapse was analyzed. The patients with AML whose donors have KIR2DL2 or KIR2DS2 had statistically significantly longer relapse-free survival (P = 0.015). Our data support previous reports that donors with KIR B-haplotype defining genes have a lower occurrence of relapse in HSCT of AML patients. Determination of donor KIR haplotypes could be a useful addition for a risk assessment of HSCT especially in AML patients.
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Affiliation(s)
- Ulla Impola
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Hannu Turpeinen
- Institute of Biosciences and Medical Technology (BioMediTech), University of Tampere , Tampere , Finland
| | - Noora Alakulppi
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Tiina Linjama
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Liisa Volin
- Division of Hematology, Helsinki University Central Hospital , Helsinki , Finland
| | - Riitta Niittyvuopio
- Division of Hematology, Helsinki University Central Hospital , Helsinki , Finland
| | - Jukka Partanen
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Satu Koskela
- FRC Blood Service, Research and Development , Helsinki , Finland
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240
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Guma SR, Lee DA, Ling Y, Gordon N, Kleinerman ES. Aerosol interleukin-2 induces natural killer cell proliferation in the lung and combination therapy improves the survival of mice with osteosarcoma lung metastasis. Pediatr Blood Cancer 2014; 61:1362-8. [PMID: 24610870 PMCID: PMC4144337 DOI: 10.1002/pbc.25019] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/12/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND We have previously shown that aerosol interleukin-2 (IL-2) increased the number of intravenously injected human natural killer (NK) cells in the lungs. In this study we investigated whether this increase was secondary to NK cell proliferation and determined the site of the proliferation. MATERIALS AND METHODS Nude mice with osteosarcoma lung metastases were injected with NK cells and treated with aerosol IL-2 or aerosol PBS. BrdU was injected prior to euthanasia to identify proliferating NK cells. The percentage of proliferating NK cells in the lung, bone marrow, spleen, and liver was determined using flow cytometry. Survival studies for mice with osteosarcoma lung metastasis treated with aerosol PBS, aerosol IL-2 alone, aerosol PBS plus NK cells, and aerosol IL-2 plus NK cells were also performed. RESULTS Treatment with aerosol IL-2 induced the proliferation of injected NK cells in the lung. Aerosol IL-2 did not increase the proliferation of NK cells in the spleen and liver. Treatment with aerosol IL-2 and aerosol IL-2 plus NK cells increased the overall survival of mice with osteosarcoma lung metastasis. CONCLUSION Aerosol IL-2 increases lung NK cell numbers by stimulating local NK cell proliferation. Aerosol IL-2's effect on NK cell proliferation is organ specific, which makes it ideal for the specific targeting of lung metastasis. Aerosol IL-2 plus NK cell therapy induced metastatic regression and increased overall survival demonstrating the potential of this therapeutic approach for patients with osteosarcoma.
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Affiliation(s)
- Sergei R. Guma
- Division of Pediatrics; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Dean A. Lee
- Division of Pediatrics; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Yu Ling
- Division of Pediatrics; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Nancy Gordon
- Division of Pediatrics; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Eugenie S. Kleinerman
- Division of Pediatrics; The University of Texas MD Anderson Cancer Center; Houston Texas
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241
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Zhao XY, Chang YJ, Xu LP, Zhang XH, Liu KY, Li D, Huang XJ. HLA and KIR genotyping correlates with relapse after T-cell-replete haploidentical transplantation in chronic myeloid leukaemia patients. Br J Cancer 2014; 111:1080-8. [PMID: 25077441 PMCID: PMC4453853 DOI: 10.1038/bjc.2014.423] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/24/2014] [Accepted: 07/07/2014] [Indexed: 11/21/2022] Open
Abstract
Background: Conflicting results have been reported regarding the predicative roles of alloreactive natural killer (NK) cells on the outcomes of transplantation in leukaemia patients. Methods: We prospectively analysed the human leukocyte antigen (HLA) typing of donor–recipient pairs and the KIR typing of the donors in 97 CML patients to address the predictive roles of NK cells in relapse undergoing T-cell-replete haploidentical transplantation. Results: Patients with class I ligands for the donor-inhibitory KIR gene exhibited decreased molecular and haematologic relapse rates (P=0.003 and P=0.015, respectively). There was a significantly reduced risk of molecular and haematologic relapse in patients with HLA-C1C2 or C2C2 who accepted donors with KIR2DS1 or in patients with HLA-Bw4 who accepted donors with KIR3DS1 (‘recipient with relevant KIR ligand for donor-activating KIR', n=25), compared with the remaining transplants (n=72, P=0.009 and P=0.009, respectively). In addition, the presence of class I ligand in the recipients of donor-activating KIR contributed to a decreased relapse rate in patients lacking class I ligand in the recipient of donor-inhibitory KIR (P=0.04 and P=0.03, respectively). Conclusions: This study suggests that the presence of class I ligands for the donor-activating or donor-inhibitory KIR gene in the recipient might confer some protection against leukaemic relapse in T-cell-replete haploidentical transplantation.
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Affiliation(s)
- X-Y Zhao
- Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - Y-J Chang
- Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - L-P Xu
- Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - X-H Zhang
- Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - K-Y Liu
- Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - D Li
- Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - X-J Huang
- 1] Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China [2] Peking-Tsinghua Center for Life Sciences, Beijing 100871, China
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242
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Lankester AC, Locatelli F, Bader P, Rettinger E, Egeler M, Katewa S, Pulsipher MA, Nierkens S, Schultz K, Handgretinger R, Grupp SA, Boelens JJ, Bollard CM. Will post-transplantation cell therapies for pediatric patients become standard of care? Biol Blood Marrow Transplant 2014; 21:402-11. [PMID: 25064748 DOI: 10.1016/j.bbmt.2014.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/15/2014] [Indexed: 01/29/2023]
Abstract
Although allogeneic hematopoietic stem cell transplantation (HSCT) is a curative approach for many pediatric patients with hematologic malignancies and some nonmalignant disorders, some critical obstacles remain to be overcome, including relapse, engraftment failure, graft-versus-host disease (GVHD), and infection. Harnessing the immune system to induce a graft-versus-tumor effect or rapidly restore antiviral immunity through the use of donor lymphocyte infusion (DLI) has been remarkably successful in some settings. Unfortunately, however, the responses to DLI can be variable, and GVHD is common. Thus, manipulations to minimize GVHD while restoring antiviral immunity and enhancing the graft-versus-tumor effect are needed to improve outcomes after allogeneic HSCT. Cellular therapies, defined as treatment modalities in which hematopoietic or nonhematopoietic cells are used as therapeutic agents, offer this promise for improving outcomes post-HSCT. This review presents an overview of the field for pediatric cell therapies in the transplant setting and discusses how we can broaden applicability beyond phase I.
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Affiliation(s)
- Arjan C Lankester
- Division of Stem Cell Transplantation, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, IRCCS Istituto Di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico, Bambino Gesù, Rome, Italy
| | - Peter Bader
- Department of Stem Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main, Germany
| | - Eva Rettinger
- Department of Stem Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main, Germany
| | - Maarten Egeler
- Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Satyendra Katewa
- Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Michael A Pulsipher
- Primary Children's Hospital, Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute/University of Utah School of Medicine, Salt Lake City, Utah
| | - Stefan Nierkens
- Utrecht-Dendritic cells AgaiNst CancEr (U-DANCE), Lab Translational Immunology, Utrecht center for Diagnostic Advances in Immunology Research (U-DAIR), Lab Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kirk Schultz
- BC Children's Hospital, Division of Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rupert Handgretinger
- Department of Pediatric Hematology/Oncology, Children's University Hospital, University of Tübingen, Tübingen, Germany
| | - Stephan A Grupp
- Division of Oncology, The Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jaap Jan Boelens
- Department of Pediatrics, Blood and Marrow Transplantation Program, Utrecht-Dendritic cells AgaiNst CancEr (U-DANCE), Lab Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Catherine M Bollard
- Departments of Pediatrics and Microbiology, Immunology and Tropical Medicine, Children's National Health System and George Washington University, Division of Pediatric Hematology-Oncology, Washington, DC
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243
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HLA-haploidentical transplantation with regulatory and conventional T-cell adoptive immunotherapy prevents acute leukemia relapse. Blood 2014; 124:638-44. [PMID: 24923299 DOI: 10.1182/blood-2014-03-564401] [Citation(s) in RCA: 288] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Posttransplant relapse is still the major cause of treatment failure in high-risk acute leukemia. Attempts to manipulate alloreactive T cells to spare normal cells while killing leukemic cells have been unsuccessful. In HLA-haploidentical transplantation, we reported that donor-derived T regulatory cells (Tregs), coinfused with conventional T cells (Tcons), protected recipients against graft-versus-host disease (GVHD). The present phase 2 study investigated whether Treg-Tcon adoptive immunotherapy prevents posttransplant leukemia relapse. Forty-three adults with high-risk acute leukemia (acute myeloid leukemia 33; acute lymphoblastic leukemia 10) were conditioned with a total body irradiation-based regimen. Grafts included CD34(+) cells (mean 9.7 × 10(6)/kg), Tregs (mean 2.5 × 10(6)/kg), and Tcons (mean 1.1 × 10(6)/kg). No posttransplant immunosuppression was given. Ninety-five percent of patients achieved full-donor type engraftment and 15% developed ≥grade 2 acute GVHD. The probability of disease-free survival was 0.56 at a median follow-up of 46 months. The very low cumulative incidence of relapse (0.05) was significantly better than in historical controls. These results demonstrate the immunosuppressive potential of Tregs can be used to suppress GVHD without loss of the benefits of graft-versus-leukemia (GVL) activity. Humanized murine models provided insights into the mechanisms underlying separation of GVL from GVHD, suggesting the GVL effect is due to largely unopposed Tcon alloantigen recognition in bone marrow.
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244
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Boudreau JE, Le Luduec JB, Hsu KC. Development of a novel multiplex PCR assay to detect functional subtypes of KIR3DL1 alleles. PLoS One 2014; 9:e99543. [PMID: 24919192 PMCID: PMC4053526 DOI: 10.1371/journal.pone.0099543] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/16/2014] [Indexed: 11/18/2022] Open
Abstract
Among NK cell receptor-ligand partnerships, KIR3DL1 and HLA-Bw4 demonstrate the greatest diversity; permutations of their allelic combinations titrate NK reactivity. Balancing selection has maintained distinct subtypes of KIR3DL1 alleles in global populations, implying that each may provide unique fitness advantages and variably influence disease processes. Though approaches exist for determining HLA-B allotypes, practical methods for identifying KIR3DL1 alleles are lacking. We have developed a PCR-based approach that identifies functional subtypes of KIR3DL1 alleles; it is suitable for research and may have clinical application. Six allele subsets were identified based on expression characteristics of the eleven most common KIR3DL1 alleles represented in reported populations. The remaining 62 low-frequency alleles were distributed into these groups based on sequence homology to coding regions. Subtype-specific SNPs were found in exons 3, 4, and 7, and used as priming sites for five multiplex PCR reactions. Genomic DNA derived from 175 unrelated donors and 52 related individuals from 6 families demonstrated >99.5% concordance between sequence-based typing and our novel approach. Finally, PCR-based typing accurately predicted NK phenotypes obtained by flow cytometry after staining with DX9 and Z27 monoclonal antibodies. This novel approach facilitates high-throughput analysis of KIR3DL1 allotypes to enable a broader understanding of KIR3DL1 and HLA-Bw4 interaction in health and disease.
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Affiliation(s)
- Jeanette E. Boudreau
- Immunology Program, Sloan-Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Jean-Benoît Le Luduec
- Immunology Program, Sloan-Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Katharine C. Hsu
- Immunology Program, Sloan-Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
- Weill Medical College, Cornell University, New York, New York, United States of America
- * E-mail:
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245
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Davies JOJ, Stringaris K, Barrett AJ, Rezvani K. Opportunities and limitations of natural killer cells as adoptive therapy for malignant disease. Cytotherapy 2014; 16:1453-1466. [PMID: 24856895 DOI: 10.1016/j.jcyt.2014.03.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
Although natural killer (NK) cells can be readily generated for adoptive therapy with current techniques, their optimal application to treat malignant diseases requires an appreciation of the dynamic balance between signals that either synergize with or antagonize each other. Individuals display wide differences in NK function that determine their therapeutic efficacy. The ability of NK cells to kill target cells or produce cytokines depends on the balance between signals from activating and inhibitory cell-surface receptors. The selection of NK cells with a predominant activating profile is critical for delivering successful anti-tumor activity. This can be achieved through selection of killer immunoglobulin-like receptor-mismatched NK donors and by use of blocking molecules against inhibitory pathways. Optimum NK cytotoxicity may require licensing or priming with tumor cells. Recent discoveries in the molecular and cellular biology of NK cells inform in the design of new strategies, including adjuvant therapies, to maximize the cytotoxic potential of NK cells for adoptive transfer to treat human malignancies.
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Affiliation(s)
- James O J Davies
- Department of Haematology, Imperial College London, London, United Kingdom
| | - Kate Stringaris
- Department of Haematology, Imperial College London, London, United Kingdom
| | - A John Barrett
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Katayoun Rezvani
- Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA.
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246
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KIR haplotype B donors but not KIR-ligand mismatch result in a reduced incidence of relapse after haploidentical transplantation using reduced intensity conditioning and CD3/CD19-depleted grafts. Ann Hematol 2014; 93:1579-86. [PMID: 24771045 DOI: 10.1007/s00277-014-2084-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/08/2014] [Indexed: 10/25/2022]
Abstract
Natural killer (NK)-cell alloreactivity after allogeneic hematopoietic cell transplantation (HCT) is influenced by the interaction of killer-cell immunoglobulin-like receptors (KIRs) on donor NK cells and human leukocyte antigen (HLA) class I ligands on recipient cells. We investigated the influence of donor KIR haplotype and KIR-ligand mismatch (MM) on relapse in 57 patients with hematologic malignancies receiving haploidentical HCT after reduced intensity conditioning and graft CD3/CD19 depletion. Of the 57 donors, 17 had KIR haplotype A (29.8 %) and 40 had KIR haplotype B (70.2 %). A KIR-ligand MM was found in 34 of 57 patients (59.6 %). There was no difference between donor KIR haplotypes in non-relapse mortality (NRM, p = 0.200) but had a significantly reduced incidence of relapse for patients with a haplotype B donor (p = 0.001). In particular, patients in partial remission (PR) benefited more from a haplotype B graft (p = 0.008) than patients in complete remission (CR, p = 0.297). Evaluating KIR-ligand MM cumulative incidences of relapse (p = 0.680) or NRM (p = 0.579), we found no significant difference. In conclusion, in the setting of reduced intensity conditioning (RIC) and CD3/CD19-depleted haploidentical HCT, we could not confirm the positive data with KIR-ligand MM but observed a significant lower risk of relapse with a KIR haplotype B donor.
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247
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Cooley S, Weisdorf DJ, Guethlein LA, Klein JP, Wang T, Marsh SGE, Spellman S, Haagenson MD, Saeturn K, Ladner M, Trachtenberg E, Parham P, Miller JS. Donor killer cell Ig-like receptor B haplotypes, recipient HLA-C1, and HLA-C mismatch enhance the clinical benefit of unrelated transplantation for acute myelogenous leukemia. THE JOURNAL OF IMMUNOLOGY 2014; 192:4592-600. [PMID: 24748496 DOI: 10.4049/jimmunol.1302517] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Killer cell Ig-like receptors (KIRs) interact with HLA class I ligands to regulate NK cell development and function. These interactions affect the outcome of unrelated donor hematopoietic cell transplantation (HCT). We have shown previously that donors with KIR B versus KIR A haplotypes improve the clinical outcome for patients with acute myelogenous leukemia by reducing the incidence of leukemic relapse and improving leukemia-free survival (LFS). Both centromeric and telomeric KIR B genes contribute to the effect, but the centromeric genes are dominant. They include the genes encoding inhibitory KIRs that are specific for the C1 and C2 epitopes of HLA-C. We used an expanded cohort of 1532 T cell-replete transplants to examine the interaction between donor KIR B genes and recipient class I HLA KIR ligands. The relapse protection associated with donor KIR B is enhanced in recipients who have one or two C1-bearing HLA-C allotypes, compared with C2 homozygous recipients, with no effect due to donor HLA. The protective interaction between donors with two or more, versus none or one, KIR B motifs and recipient C1 was specific to transplants with class I mismatch at HLA-C (RR of leukemia-free survival, 0.57 [0.40-0.79]; p = 0.001) irrespective of the KIR ligand mismatch status of the transplant. The survival advantage and relapse protection in C1/x recipients compared with C2/C2 recipients was similar irrespective of the particular donor KIR B genes. Understanding the interactions between donor KIR and recipient HLA class I can be used to inform donor selection to improve outcome of unrelated donor hematopoietic cell transplantation for acute myelogenous leukemia.
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Affiliation(s)
- Sarah Cooley
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN 55455
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Muraji T. Maternal microchimerism in biliary atresia: are maternal cells effector cells, targets, or just bystanders? CHIMERISM 2014; 5:1-5. [PMID: 24670921 DOI: 10.4161/chim.28576] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The etiology of biliary atresia (BA) is unknown; however, the liver histology is similar to that observed in immune-mediated hepatic disorders. Liver fibrosis in BA progresses even after bile drainage has been achieved by the Kasai operation. Maternal microchimerism has been purported to play a part in the pathogenesis of BA as well as certain autoimmune diseases. However, the role of maternal cells has not yet been determined in BA. Specifically, it is unknown whether these maternal cells function as maternal effector T lymphocytes, or targets or bystanders. We currently hypothesize that the first hit is due to GvHD interaction by engrafted maternal effector T lymphocytes. Furthermore, we suggest that the secondary effects that are manifested by progressive cirrhosis are caused either by maternal chimeric effector T lymphocytes (e.g., GvHD interaction) or targets (e.g., HvGD interaction). Based on our hypothesis, mixed lymphocyte reactions between patients and their mothers might shed light on the etiopathogenesis and prognostic indicators.
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Affiliation(s)
- Toshihiro Muraji
- Department of Pediatric Surgery; Child Health and Cancer Research Center; Ibaraki Children's Hospital; Ibaraki, Japan
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Chretien AS, Le Roy A, Vey N, Prebet T, Blaise D, Fauriat C, Olive D. Cancer-Induced Alterations of NK-Mediated Target Recognition: Current and Investigational Pharmacological Strategies Aiming at Restoring NK-Mediated Anti-Tumor Activity. Front Immunol 2014; 5:122. [PMID: 24715892 PMCID: PMC3970020 DOI: 10.3389/fimmu.2014.00122] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/10/2014] [Indexed: 01/14/2023] Open
Abstract
Despite evidence of cancer immune-surveillance, which plays a key role in tumor rejection, cancer cells can escape immune recognition through different mechanisms. Thus, evasion to Natural killer (NK) cell-mediated anti-tumor activity is commonly described and is mediated by various mechanisms, mainly cancer cell-induced down-regulation of NK-activating receptors (NCRs, NKG2D, DNAM-1, and CD16) as well as up-regulation of inhibitory receptors (killer-cell immunoglobulin-like receptors, KIRs, NKG2A). Alterations of NK cells lead to an impaired recognition of tumor cells as well as a decreased ability to interact with immune cells. Alternatively, cancer cells downregulate expression of ligands for NK cell-activating receptors and up-regulate expression of the ligands for inhibitory receptors. A better knowledge of the extent and the mechanisms of these defects will allow developing pharmacological strategies to restore NK cell ability to recognize and lyse tumor cells. Combining conventional chemotherapy and immune modulation is a promising approach likely to improve clinical outcome in diverse neoplastic malignancies. Here, we overview experimental approaches as well as strategies already available in the clinics that restore NK cell functionality. Yet successful cancer therapies based on the manipulation of NK cell already have shown efficacy in the context of hematologic malignancies. Additionally, the ability of cytotoxic agents to increase susceptibility of tumors to NK cell lysis has been studied and may require improvement to maximize this effect. More recently, new strategies were developed to specifically restore NK cell phenotype or to stimulate NK cell functions. Overall, pharmacological immune modulation trends to be integrated in therapeutic strategies and should improve anti-tumor effects of conventional cancer therapy.
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Affiliation(s)
- Anne-Sophie Chretien
- Centre de Cancérologie de Marseille, INSERM, U1068, Institut Paoli-Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258, Marseille, France
| | - Aude Le Roy
- Centre de Cancérologie de Marseille, Plateforme d’Immunomonitoring en Cancérologie, INSERM, U1068, Institut Paoli-Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258, Marseille, France
| | - Norbert Vey
- Centre de Cancérologie de Marseille, INSERM, U1068, Institut Paoli-Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258, Marseille, France
- Département d’Hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Thomas Prebet
- Département d’Hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Didier Blaise
- Centre de Cancérologie de Marseille, INSERM, U1068, Institut Paoli-Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258, Marseille, France
- Unité de Transplantation et de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France
| | - Cyril Fauriat
- Centre de Cancérologie de Marseille, INSERM, U1068, Institut Paoli-Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258, Marseille, France
| | - Daniel Olive
- Centre de Cancérologie de Marseille, INSERM, U1068, Institut Paoli-Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258, Marseille, France
- Centre de Cancérologie de Marseille, Plateforme d’Immunomonitoring en Cancérologie, INSERM, U1068, Institut Paoli-Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258, Marseille, France
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Marcus A, Eshhar Z. Allogeneic chimeric antigen receptor-modified cells for adoptive cell therapy of cancer. Expert Opin Biol Ther 2014; 14:947-54. [PMID: 24661086 DOI: 10.1517/14712598.2014.900540] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Chimeric antigen (or antibody) receptors (CAR) are fusion proteins typically combining an antibody-derived targeting fragment with signaling domains capable of activating immune cells. Recent clinical trials have shown the tremendous potential of adoptive cell transfer (ACT) of autologous T cells engineered to express a CD19-specific CAR targeting B-cell malignancies. Building on this approach, ACT therapies employing allogeneic CAR-expressing cytotoxic cells are now being explored. AREAS COVERED The basic principles of CAR-ACT are introduced. The potential benefits as well as problems of using allogeneic CAR-modified cells against tumor antigens are discussed. Various approaches to allogeneic CAR therapy are presented, including donor leukocyte infusion, CAR-redirected γδ T cells and natural killer cells, strategies to avoid graft-versus-host disease, modulation of lymphocyte migration, and exploitation of graft-versus-host reactivity. EXPERT OPINION CAR-modified allogeneic cells have the potential to act as universal effector cells, which can be administered to any patient regardless of MHC type. Such universal effector cells could be used as an 'off-the-shelf' cell-mediated treatment for cancer.
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Affiliation(s)
- Assaf Marcus
- University of California, Department of Molecular and Cell Biology, Cancer Research Laboratory Berkeley , Berkeley, CA 94720-3200 , USA
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