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Klingel L, Siebert N, Troschke-Meurer S, Zumpe M, Ehlert K, Huber S, Loibner H, Mutschlechner O, Lode HN. Immune Response and Outcome of High-Risk Neuroblastoma Patients Immunized with Anti-Idiotypic Antibody Ganglidiomab: Results from Compassionate-Use Treatments. Cancers (Basel) 2022; 14:cancers14235802. [PMID: 36497290 PMCID: PMC9735439 DOI: 10.3390/cancers14235802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: High-risk neuroblastoma (HR-NB) is associated with a poor prognosis despite a multimodal high-intensity treatment regimen, including immunotherapy with anti-GD2 monoclonal antibodies (mAb). Here, we investigated the effects of an anti-idiotypic vaccine based on the mAb ganglidiomab that structurally mimics GD2. (2) Methods: Patients with HR-NB treated with anti-GD2 mAb dinutuximab beta and who achieved complete remission after frontline or salvage therapy were offered the vaccine (0.5 mg ganglidiomab adsorbed to Alhydrogel®). Side effects (CTCAE v4.03) and immune responses were determined on each visit. We also evaluated the time to relapse or progression until the last follow-up. (3) Results: Seven HR-NB patients (five frontlines, two relapsed) received 6-22 subcutaneous injections every two weeks. Six of the seven patients showed an immune response. The non-responding patient had a haploidentical stem cell transplantation as part of the previous treatment. No fever, pain, neuropathy, or toxicities ≥ grade 3 occurred during or post-treatment. All immunized patients did not experience relapses or progressions of their neuroblastoma. (4) Conclusions: This is the first-in-man use of the ganglidiomab vaccine, which was well-tolerated, and all patients not pre-treated by haploidentical transplantation developed vaccine-specific immune responses. These findings provide an important basis for the design of prospective clinical trials.
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Affiliation(s)
- Leah Klingel
- Pediatric Hematology and Oncology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Nikolai Siebert
- Pediatric Hematology and Oncology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Sascha Troschke-Meurer
- Pediatric Hematology and Oncology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Maxi Zumpe
- Pediatric Hematology and Oncology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Karoline Ehlert
- Pediatric Hematology and Oncology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Stefanie Huber
- Pediatric Hematology and Oncology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Hans Loibner
- Anyxis Immuno-Oncology GmbH, 1230 Vienna, Austria
| | | | - Holger N. Lode
- Pediatric Hematology and Oncology, University Medicine Greifswald, 17475 Greifswald, Germany
- Anyxis Immuno-Oncology GmbH, 1230 Vienna, Austria
- Correspondence: ; Tel.: +49-3834-86-6300
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2
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Widely applicable, extended flow cytometric stem cell enumeration panel for quality control of advanced cellular products. Sci Rep 2022; 12:17995. [PMID: 36289245 PMCID: PMC9605971 DOI: 10.1038/s41598-022-22339-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/13/2022] [Indexed: 01/24/2023] Open
Abstract
The most widely used quality control assay for CD34 + hematopoietic stem cell product characterization is the protocol established by the International Society of Hematotherapy and Graft Engineering (ISHAGE). While this protocol is still the gold standard for stem cell enumeration and viability assessment, it does not include T cell enumeration, which is nowadays mandatory for assaying standard allogeneic grafts and various advanced therapy medicinal products (ATMPs). In accordance, we have developed and extensively validated a new approach for a more comprehensive characterization of hematopoietic cellular products using a pre-formulated dried antibody format panel. In addition to the counting beads, the typical markers CD45 fluorescein isothiocyanate (FITC) and CD34 phycoerythrin (PE), as well as the viability dye 7-amino actinomycin D (7-AAD), our novel pre-formulated panel also contains CD3 Pacific Blue (PB) and CD19 allophycocyanin (APC) in the same tube, thereby allowing a combined calculation of leucocytes, stem cells, T and B cells. Showing high linearity, sensitivity and accuracy, our approach is easy to implement and enables a more in-depth characterization of the cellular product under release testing conditions. In addition, the dried pre-formulated antibody approach increases assay reliability compared to the standard antibody panel.
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3
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Bremm M, Krastel T, Cappel C, Zimmermann O, Pfeffermann LM, Katzki V, Bonig H, Schäfer R, Rettinger E, Merker M, Bremm S, Schaefer K, Klingebiel T, Soerensen J, Bader P, Huenecke S. Depletion of CD45RA + T cells: Advantages and disadvantages of different purification methods. J Immunol Methods 2021; 492:112960. [PMID: 33417916 DOI: 10.1016/j.jim.2021.112960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 12/03/2020] [Accepted: 12/31/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recently, new advances were made regarding the depletion of CD45RA+ naïve T cells from haploidentical grafts as they are suspected to be the most alloreactive. METHODS Within this project we investigated CD45RA-depletion from G-CSF mobilized PBSC by two different purification strategies according to GMP, specifically direct depletion of CD45RA+ cells (one-step approach), or CD34-positive selection followed by CD45RA-depletion (two-step approach). RESULTS With log -3.9 and - 3.8 the depletion quality of CD45RA+ T cells was equally for both approaches together with a close to complete CD19+ B cell depletion. However, due to a high expression of CD45RA the majority of NK cells were lost within both CD45RA depletion strategies. Stem cell recovery after one-step CD45RA-depletion was at median 52.0% (range: 49.7-67.2%), which was comparable to previously published recovery data received from direct CD34 positive selection. Memory T cell recovery including CD4+ and CD8+ memory T cell subsets was statistically not differing between both purification approaches. The recovery of CD4+ and CD8+ T cells was as well similar, but overall a higher amount of cytotoxic than T-helper cells were lost as indicated by an increase of the CD4/CD8 ratio. CONCLUSIONS CD45RA-depletion from G-CSF mobilized PBSC is feasible as one- and two-step approach and results in sufficient reduction of CD45RA+ T cells as well as B cells, but also to a co-depletion of NK cells. However, by gaining two independent cell products, the two-step approach enables the highest clinical flexibility in regard to individual graft composition with precise dosage of stem cells and T cells.
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Affiliation(s)
- Melanie Bremm
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany.
| | - Theresa Krastel
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Claudia Cappel
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Olga Zimmermann
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Lisa-Marie Pfeffermann
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Verena Katzki
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Halvard Bonig
- Institute for Transfusion Medicine and Immunohematology, Goethe-University Frankfurt/Main, German Red Cross Blood Donor Service Baden-Württemberg-Hessen, Frankfurt/Main, Germany
| | - Richard Schäfer
- Institute for Transfusion Medicine and Immunohematology, Goethe-University Frankfurt/Main, German Red Cross Blood Donor Service Baden-Württemberg-Hessen, Frankfurt/Main, Germany
| | - Eva Rettinger
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Michael Merker
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Sebastian Bremm
- Data Analytics & Visualization, Frankfurt University of Applied Sciences, Frankfurt/Main, Germany
| | - Kirsten Schaefer
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Thomas Klingebiel
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Jan Soerensen
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Peter Bader
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
| | - Sabine Huenecke
- Clinic for Pediatric and Adolescent Medicine, University Hospital, Frankfurt/Main, Germany
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4
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Mfarrej B, Gaude J, Couquiaud J, Calmels B, Chabannon C, Lemarie C. Validation of a flow cytometry-based method to quantify viable lymphocyte subtypes in fresh and cryopreserved hematopoietic cellular products. Cytotherapy 2020; 23:77-87. [PMID: 32718876 DOI: 10.1016/j.jcyt.2020.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/27/2020] [Accepted: 06/22/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND AIMS Adoptive cellular therapy with immune effector cells (IECs) has shown promising efficacy against some neoplastic diseases as well as potential in immune regulation. Both inherent variability in starting material and variations in cell composition produced by the manufacturing process must be thoroughly evaluated with a validated method established to quantify viable lymphocyte subtypes. Currently, commercialized immunophenotyping methods determine cell viability with significant errors in thawed products since they do not include any viability staining. We hereby report on the validation of a flow cytometry-based method for quantifying viable lymphocyte immunophenotypes in fresh and cryopreserved hematopoietic cellular products. METHODS Using fresh or frozen cellular products and stabilized blood, we report on the validation parameters accuracy, uncertainty, precision, sensitivity, robustness and contamination between samples for quantification of viable CD3+, CD4+ T cells, CD8+ T cells, CD3-CD56+CD16+/- NK cells, CD19+ B cells and CD14+ monocytes of relevance to fresh and cryopreserved hematopoietic cellular products using the Cytomics FC500 cytometer (Beckman Coulter). RESULTS The acceptance criteria set in the validation plan were all met. The method is able to accommodate the variability in absolute numbers of cells in starting materials collected or cryopreserved from patients or healthy donors (uncertainty of ≤20% at three different concentrations), stability over time (compliance over 3 years during regular inter-laboratory comparisons) and confidence in meaningful changes during cell processing and manufacturing (intra-assay and intermediate precision of 10% coefficient of variation). Furthermore, the method can accurately report on the efficacy of cell depletion since the lower limit of quantification was established (CD3+, CD4+ and CD8+ cells at 9, 8 and 8 cells/µL, respectively). The method complies with Foundation for the Accreditation of Cellular Therapy (FACT) standards for IEC, FACT-Joint Accreditation Committee of ISCT-EBMT (JACIE) hematopoietic cell therapy standards, International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Q2(R1) and International Organization for Standardization 15189 standards. Furthermore, it complies with Ligand Binding Assay Bioanalytical Focus Group/American Association of Pharmaceutical Scientists, International Council for Standardization of Hematology/International Clinical Cytometry Society and European Bioanalysis Forum recommendations for validating such methods. CONCLUSIONS The implications of this effort include standardization of viable cell immunophenotyping of starting material for cell manufacturing, cell selection and in-process quality controls or dosing of IECs. This method also complies with all relevant standards, particularly FACT-JACIE standards, in terms of enumerating and reporting on the viability of the "clinically relevant cell populations."
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Affiliation(s)
- Bechara Mfarrej
- Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France.
| | - Julie Gaude
- Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France
| | - Jerome Couquiaud
- Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France
| | - Boris Calmels
- Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France
| | | | - Claude Lemarie
- Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France
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5
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Heinze A, Grebe B, Bremm M, Huenecke S, Munir TA, Graafen L, Frueh JT, Merker M, Rettinger E, Soerensen J, Klingebiel T, Bader P, Ullrich E, Cappel C. The Synergistic Use of IL-15 and IL-21 for the Generation of NK Cells From CD3/CD19-Depleted Grafts Improves Their ex vivo Expansion and Cytotoxic Potential Against Neuroblastoma: Perspective for Optimized Immunotherapy Post Haploidentical Stem Cell Transplantation. Front Immunol 2019; 10:2816. [PMID: 31849984 PMCID: PMC6901699 DOI: 10.3389/fimmu.2019.02816] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/15/2019] [Indexed: 12/21/2022] Open
Abstract
Neuroblastoma (NB) is the most common solid extracranial tumor in childhood. Despite therapeutic progress, prognosis in high-risk NB is poor and innovative therapies are urgently needed. Therefore, we addressed the potential cytotoxic capacity of interleukin (IL)-activated natural killer (NK) cells compared to cytokine-induced killer (CIK) cells for the treatment of NB. NK cells were isolated from peripheral blood mononuclear cells (PBMCs) by indirect CD56-enrichment or CD3/CD19-depletion and expanded with different cytokine combinations, such as IL-2, IL-15, and/or IL-21 under feeder-cell free conditions. CIK cells were generated from PBMCs by ex vivo stimulation with interferon-γ, IL-2, OKT-3, and IL-15. Comparative analysis of expansion rate, purity, phenotype and cytotoxicity was performed. CD56-enriched NK cells showed a median expansion rate of 4.3-fold with up to 99% NK cell content. The cell product after CD3/CD19-depletion consisted of a median 43.5% NK cells that expanded significantly faster reaching also 99% of NK cell purity. After 10–12 days of expansion, both NK cell preparations showed a significantly higher median cytotoxic capacity against NB cells relative to CIK cells. Remarkably, these NK cells were also capable of efficiently killing NB spheroidal 3D culture in long-term cytotoxicity assays. Further optimization using a novel NK cell culture medium and a prolonged culturing procedure after CD3/CD19-depletion for up to 15 days enhanced the expansion rate up to 24.4-fold by maintaining the cytotoxic potential. Addition of an IL-21 boost prior to harvesting significantly increased the cytotoxicity. The final cell product consisted for the major part of CD16−, NCR-expressing, poly-functional NK cells with regard to cytokine production, CD107a degranulation and antitumor capacity. In summary, our study revealed that NK cells have a significantly higher cytotoxic potential to combat NB than CIK cell products, especially following the synergistic use of IL-15 and IL-21 for NK cell activation. Therefore, the use of IL-15+IL-21 expanded NK cells generated from CD3/CD19-depleted apheresis products seems to be highly promising as an immunotherapy in combination with haploidentical stem cell transplantation (SCT) for high-risk NB patients.
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Affiliation(s)
- Annekathrin Heinze
- Experimental Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Beatrice Grebe
- Experimental Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Melanie Bremm
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sabine Huenecke
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Tasleem Ah Munir
- Experimental Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Lea Graafen
- Experimental Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Jochen T Frueh
- Experimental Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Michael Merker
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Eva Rettinger
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Jan Soerensen
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Thomas Klingebiel
- Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Peter Bader
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Evelyn Ullrich
- Experimental Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt am Main, Frankfurt am Main, Germany
| | - Claudia Cappel
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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6
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Elfeky R, Shah RM, Unni MNM, Ottaviano G, Rao K, Chiesa R, Amrolia P, Worth A, Flood T, Abinun M, Hambleton S, Cant AJ, Gilmour K, Adams S, Ahsan G, Barge D, Gennery AR, Qasim W, Slatter M, Veys P. New graft manipulation strategies improve the outcome of mismatched stem cell transplantation in children with primary immunodeficiencies. J Allergy Clin Immunol 2019; 144:280-293. [PMID: 30731121 DOI: 10.1016/j.jaci.2019.01.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 01/11/2019] [Accepted: 01/17/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Mismatched stem cell transplantation is associated with a high risk of graft loss, graft-versus-host disease (GvHD), and transplant-related mortality. Alternative graft manipulation strategies have been used over the last 11 years to reduce these risks. OBJECTIVE We investigated the outcome of using different graft manipulation strategies among children with primary immunodeficiencies. METHODS Between 2006 and 2017, 147 patients with primary immunodeficiencies received 155 mismatched grafts: 30 T-cell receptor (TCR) αβ/CD19-depleted grafts, 43 cord blood (CB) grafts (72% with no serotherapy), 17 CD34+ selection with T-cell add-back grafts, and 65 unmanipulated grafts. RESULTS The estimated 8-year survival of the entire cohort was 79%, transplant-related mortality was 21.7%, and the graft failure rate was 6.7%. Posttransplantation viral reactivation, grade II to IV acute graft-versus-host disease (aGvHD), and chronic graft-versus-host disease (cGvHD) complicated 49.6%, 35%, and 15% of transplantations, respectively. Use of TCRαβ/CD19 depletion was associated with a significantly lower incidence of grade II to IV aGvHD (11.5%) and cGvHD (0%), although with a greater incidence of viral reactivation (70%) in comparison with other grafts. T-cell immune reconstitution was robust among CB transplants, although with a high incidence (56.7%) of grade II to IV aGvHD. Stable full donor engraftment was significantly greater at 80% among TCRαβ+/CD19+-depleted and CB transplants versus 40% to 60% among the other groups. CONCLUSIONS Rapidly accessible CB and haploidentical grafts are suitable alternatives for patients with no HLA-matched donor. Cord transplantation without serotherapy and TCRαβ+/CD19+-depleted grafts produced comparable survival rates of around 80%, although with a high rate of aGvHD with the former and a high risk of viral reactivation with the latter that need to be addressed.
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Affiliation(s)
- Reem Elfeky
- Molecular and Cellular Immunology Unit, University College London (UCL) Great Ormond Street Institute of Child Health, London, United Kingdom; Department of Paediatric Allergy and Immunology, Ain Shams University, Cairo, Egypt.
| | - Ravi M Shah
- Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom; Department of Paediatric Oncology and BMT, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Mohamed N M Unni
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Giorgio Ottaviano
- Department of Paediatrics, Fondazione MBBM University of Milan-Bicocca, Monza, Italy
| | - Kanchan Rao
- Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
| | - Robert Chiesa
- Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
| | - Persis Amrolia
- Molecular and Cellular Immunology Unit, University College London (UCL) Great Ormond Street Institute of Child Health, London, United Kingdom; Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
| | - Austen Worth
- Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
| | - Terry Flood
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Mario Abinun
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Sophie Hambleton
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Andrew J Cant
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Kimberly Gilmour
- Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
| | - Stuart Adams
- Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
| | - Gul Ahsan
- Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
| | - Dawn Barge
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Andrew R Gennery
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Waseem Qasim
- Molecular and Cellular Immunology Unit, University College London (UCL) Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mary Slatter
- Host Defence Unit, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Paul Veys
- Molecular and Cellular Immunology Unit, University College London (UCL) Great Ormond Street Institute of Child Health, London, United Kingdom; Blood and Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, United Kingdom
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7
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Abstract
Allogeneic haematopoietic stem cell transplantation (HSCT) from an human leukocyte antigen (HLA)-identical donor can be curative for eligible patients with non-malignant and malignant haematological disorders. HSCT from alternative donor sources, such as HLA-mismatched haploidentical donors, is increasingly considered as a viable therapeutic option for patients lacking HLA-matched donors. Initial attempts at haploidentical HSCT were associated with vigorous bidirectional alloreactivity, leading to unacceptably high rates of graft rejection and graft-versus-host disease (GVHD). More recently, new approaches for mitigating harmful T-cell alloreactivity that mediates GVHD, while preserving the function of tumour-reactive natural killer (NK) cells and γδ T cells, have led to markedly improved clinical outcomes, and are successfully being implemented in the clinic. This article will provide an update on in vitro strategies and in vivo approaches aimed at preventing GVHD by selectively manipulating key components of the adaptive immune response, such as T-cell receptor (TCR)-αβ T cells and CD45RA-expressing naive T cells.
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8
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Huenecke S, Bremm M, Cappel C, Esser R, Quaiser A, Bonig H, Jarisch A, Soerensen J, Klingebiel T, Bader P, Koehl U. Optimization of individualized graft composition: CD3/CD19 depletion combined with CD34 selection for haploidentical transplantation. Transfusion 2016; 56:2336-45. [DOI: 10.1111/trf.13694] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/04/2016] [Accepted: 05/07/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Sabine Huenecke
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Melanie Bremm
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Claudia Cappel
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Ruth Esser
- GMP Development UnitInstitute of Cellular Therapeutics, IFB‐TX, Hannover Medical SchoolHannover Germany
| | - Andrea Quaiser
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Halvard Bonig
- Division for Cell ProcessingInstitute for Transfusion Medicine and Immunohematology, Goethe‐University Frankfurt/Main
- German Red Cross Blood Donor Service, Baden‐Württemberg‐HessenFrankfurt/Main, Germany
| | - Andrea Jarisch
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Jan Soerensen
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Thomas Klingebiel
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Peter Bader
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Ulrike Koehl
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
- GMP Development UnitInstitute of Cellular Therapeutics, IFB‐TX, Hannover Medical SchoolHannover Germany
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