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Hadjis AD, McCurdy SR. The role and novel use of natural killer cells in graft-versus-leukemia reactions after allogeneic transplantation. Front Immunol 2024; 15:1358668. [PMID: 38817602 PMCID: PMC11137201 DOI: 10.3389/fimmu.2024.1358668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/28/2024] [Indexed: 06/01/2024] Open
Abstract
Allogeneic hematopoietic cell transplantation (HCT) has transformed over the past several decades through enhanced supportive care, reduced intensity conditioning (RIC), improved human leukocyte antigen (HLA) typing, and novel graft-versus-host disease (GVHD)-prevention and treatment strategies. Most notably, the implementation of post-transplantation cyclophosphamide (PTCy) has dramatically increased the safety and availability of this life-saving therapy. Given reductions in nonrelapse mortality (NRM) with these advances, the HCT community has placed even greater emphasis on developing ways to reduce relapse - the leading cause of death after HCT. When using RIC HCT, protection from relapse relies predominantly on graft-versus-leukemia (GVL) reactions. Donor lymphocyte infusion (DLI), adoptive cellular therapy, checkpoint inhibition, and post-HCT maintenance strategies represent approaches under study that aim to augment or synergize with the GVL effects of HCT. Optimizing donor selection algorithms to leverage GVL represents another active area of research. Many of these strategies seek to harness the effects of T cells, which for decades were felt to be the primary mediators of GVL and the focus of investigation in relapse reduction. However, there is growing interest in capitalizing on the ability of natural killer (NK) cells to yield potent anti-tumor effects. A potential advantage of NK cell-based approaches over T cell-mediated is the potential to reduce NRM in addition to relapse. By decreasing infection, without increasing the risk of GVHD, NK cells may mitigate NRM, while still yielding relapse reduction through identification and clearance of cancer cells. Most T cell-focused relapse-prevention strategies must weigh the benefits of relapse reduction against the increased risk of NRM from GVHD. In contrast, NK cells have the potential to reduce both, potentially tipping the scales significantly in favor of survival. Here, we will review the role of NK cells in GVL, optimization of NK cell match or mismatch, and burgeoning areas of research in NK cell therapy such as adoptive transfer and chimeric antigen receptor (CAR) NK cells.
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Affiliation(s)
- Ashley D. Hadjis
- Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
| | - Shannon R. McCurdy
- Abramson Cancer Center and the Division of Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
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2
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Schmid C, Kuball J, Bug G. Defining the Role of Donor Lymphocyte Infusion in High-Risk Hematologic Malignancies. J Clin Oncol 2021; 39:397-418. [PMID: 33434060 DOI: 10.1200/jco.20.01719] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Christoph Schmid
- Department of Hematology and Oncology, Augsburg University Hospital, Augsburg, Germany
| | - Jürgen Kuball
- Department of Hematology and Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gesine Bug
- Department of Medicine 2, Goethe University, Frankfurt am Main, Germany
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Jaiswal SR, Chakraborty S, Lakhchaura R, Shashi P, Mehta A, Soni M, Chakrabarti S. Early and Sustained Expansion of Adaptive Natural Killer Cells Following Haploidentical Transplantation and CTLA4Ig-Primed Donor Lymphocyte Infusions Dissociate Graft-versus-Leukemia and Graft-versus-Host Effects. Transplant Cell Ther 2020; 27:144-151. [PMID: 33830023 DOI: 10.1016/j.jtct.2020.10.005] [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: 08/27/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Adaptive or memory natural killer (NK) cells with epigenetic imprints similar to memory T cells have been shown to develop in response to cytomegalovirus (CMV) infection with upregulation of activating receptor NKG2C. These cells have been shown to possess strong anti-tumour efficacy both in-vitro as well as in-vivo. OBJECTIVES To determine if reconstitution of adaptive NK cells (CD56dimNKG2C+NKG2A-) in patients with advanced leukemia undergoing haploidentical HCT had any impact on disease progression (DP). STUDY DESIGN The study cohort comprised of 60 patients with advanced acute leukemia, aged 2-65 years, receiving myeloablative PTCy based haploidentical transplantation from CMV seropositive donors, followed by CTLA4Ig-primed donor lymphocyte infusions (DLI). They were evaluated for the kinetics of reconstitution of adaptive NK cells, both phenotypic and functional, at days +30,+60, +90 and at regular intervals, to 3 years of follow-up, in relation to DP. Reconstitution of adaptive NK cells was compared with a retrospective cohort of patients in the same protocol receiving DLI without CTLA4Ig. RESULTS Non-relapse mortality, acute and chronic GVHD were 5.1%, 10.3% and 14.5%. DP was 17.5% at a median follow-up of 28 months. Adaptive NK cells were significantly higher in patients without DP at days+30, +60 and +90 (p = 0.0001), irrespective of CMV reactivation and remained elevated until 36 months post-HCT. These cells maintained their functional competence as measured by robust interferon-gamma production with higher expressions of KIR, NKG2D and CD57, without any increase in PD1 expression. Grafts from donors with higher adaptive NK cells were associated with a lower risk of DP (p = 0.0001). In multivariate analysis, adaptive NK cell recovery at day +90 had the most favorable impact on DP (HR-0.7). Tregs reconstituted briskly along with the adaptive NK cells and were sustained as well, without compromising the GVL effect. Comparison with a retrospective cohort receiving the same protocol with DLI without CTLA4Ig, showed a superior reconstitution of adaptive NK cells in those receiving CTLA4Ig-DLI (p < 0.0001). CONCLUSION Our study suggests that myeloablative transplantation from CMV seropositive haploidentical donors augmented with CTLA4Ig-primed DLI might favor early and sustained expansion of functionally competent adaptive NK cells irrespective of CMV reactivation, with a favorable outcome.
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Affiliation(s)
- Sarita Rani Jaiswal
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; BMT Research Lab, Department of Blood and Marrow Transplantation & Hematology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India.
| | - Sushmita Chakraborty
- Department of Transplant Immunology & Immunogenetics, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Lakhchaura
- BMT Research Lab, Department of Blood and Marrow Transplantation & Hematology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Pooja Shashi
- BMT Research Lab, Department of Blood and Marrow Transplantation & Hematology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Anupama Mehta
- BMT Research Lab, Department of Blood and Marrow Transplantation & Hematology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Mayank Soni
- BMT Research Lab, Department of Blood and Marrow Transplantation & Hematology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Suparno Chakrabarti
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; BMT Research Lab, Department of Blood and Marrow Transplantation & Hematology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
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Jaiswal SR, Bhakuni P, Soni M, Gupta M, Thatai A, Chakrabarti S. Safety and efficacy of Sofosbuvir and Velpatasvir in children with active hepatitis C virus infection undergoing haploidentical transplantation. Transpl Infect Dis 2020; 23:e13490. [DOI: 10.1111/tid.13490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/16/2020] [Accepted: 10/04/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Sarita Rani Jaiswal
- Cellular Therapy and Immunology Manashi Chakrabarti Foundation Kolkata India
- Department of Blood and Marrow Transplantation & Hematology Dharamshila Narayana Super‐Speciality Hospital and Research Centre New Delhi India
| | - Prakash Bhakuni
- Cellular Therapy and Immunology Manashi Chakrabarti Foundation Kolkata India
- Department of Blood and Marrow Transplantation & Hematology Dharamshila Narayana Super‐Speciality Hospital and Research Centre New Delhi India
| | - Mayank Soni
- Department of Blood and Marrow Transplantation & Hematology Dharamshila Narayana Super‐Speciality Hospital and Research Centre New Delhi India
| | - Mahesh Gupta
- Department of Gastroenterology Dharamshila Narayana Super‐Speciality Hospital New Delhi India
| | - Atul Thatai
- Molecular Diagnostics and R&D Dr LalPathLabs Ltd New Delhi India
| | - Suparno Chakrabarti
- Cellular Therapy and Immunology Manashi Chakrabarti Foundation Kolkata India
- Department of Blood and Marrow Transplantation & Hematology Dharamshila Narayana Super‐Speciality Hospital and Research Centre New Delhi India
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Vandenhove B, Canti L, Schoemans H, Beguin Y, Baron F, Graux C, Kerre T, Servais S. How to Make an Immune System and a Foreign Host Quickly Cohabit in Peace? The Challenge of Acute Graft- Versus-Host Disease Prevention After Allogeneic Hematopoietic Cell Transplantation. Front Immunol 2020; 11:583564. [PMID: 33193397 PMCID: PMC7609863 DOI: 10.3389/fimmu.2020.583564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/21/2020] [Indexed: 01/16/2023] Open
Abstract
Allogeneic hematopoietic cell transplantation (alloHCT) has been used as cellular immunotherapy against hematological cancers for more than six decades. Its therapeutic efficacy relies on the cytoreductive effects of the conditioning regimen but also on potent graft-versus-tumor (GVT) reactions mediated by donor-derived immune cells. However, beneficial GVT effects may be counterbalanced by acute GVHD (aGVHD), a systemic syndrome in which donor immune cells attack healthy tissues of the recipient, resulting in severe inflammatory lesions mainly of the skin, gut, and liver. Despite standard prophylaxis regimens, aGVHD still occurs in approximately 20–50% of alloHCT recipients and remains a leading cause of transplant-related mortality. Over the past two decades, advances in the understanding its pathophysiology have helped to redefine aGVHD reactions and clinical presentations as well as developing novel strategies to optimize its prevention. In this review, we provide a brief overview of current knowledge on aGVHD immunopathology and discuss current approaches and novel strategies being developed and evaluated in clinical trials for aGVHD prevention. Optimal prophylaxis of aGVHD would prevent the development of clinically significant aGVHD, while preserving sufficient immune responsiveness to maintain beneficial GVT effects and immune defenses against pathogens.
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Affiliation(s)
- Benoît Vandenhove
- Laboratory of Hematology, GIGA-I3, GIGA Institute, University of Liège, Liège, Belgium
| | - Lorenzo Canti
- Laboratory of Hematology, GIGA-I3, GIGA Institute, University of Liège, Liège, Belgium
| | - Hélène Schoemans
- Department of Clinical Hematology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Yves Beguin
- Laboratory of Hematology, GIGA-I3, GIGA Institute, University of Liège, Liège, Belgium.,Department of Clinical Hematology, CHU of Liège, University of Liège, Liège, Belgium
| | - Frédéric Baron
- Laboratory of Hematology, GIGA-I3, GIGA Institute, University of Liège, Liège, Belgium.,Department of Clinical Hematology, CHU of Liège, University of Liège, Liège, Belgium
| | - Carlos Graux
- Department of Clinical Hematology, CHU UCL Namur (Godinne), Université Catholique de Louvain, Yvoir, Belgium
| | - Tessa Kerre
- Hematology Department, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Sophie Servais
- Laboratory of Hematology, GIGA-I3, GIGA Institute, University of Liège, Liège, Belgium.,Department of Clinical Hematology, CHU of Liège, University of Liège, Liège, Belgium
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CTLA4Ig-primed donor lymphocyte infusions following haploidentical transplantation improve outcome with a distinct pattern of early immune reconstitution as compared to conventional donor lymphocyte infusions in advanced hematological malignancies. Bone Marrow Transplant 2020; 56:185-194. [PMID: 32704091 DOI: 10.1038/s41409-020-01002-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/29/2020] [Accepted: 07/14/2020] [Indexed: 11/09/2022]
Abstract
CTLA4Ig has a unique property to spare or even potentiate natural killer (NK) cell-mediated cytotoxicity, whilst inhibiting T cell activation. We explored the efficacy of prophylactic DLI following CTLA4Ig (CTLA4Ig-DLI group, n = 75), compared to conventional DLI (DLI group, n = 50), in patients with advanced hematological malignancies receiving PTCy-based haploidentical transplantation. Acute and chronic GVHD in the CTLA4Ig-DLI group were 9.6% and 15.3% compared to 18.8% [p = 0.09] and 36.5% [p = 0.01] in the DLI group. Both non-relapse mortality (4% vs 14.4%) and disease progression (DP) (15.7% vs 31.1%) were lower in CTLA4Ig-DLI group (p = 0.04). GVHD and progression-free survival was significantly improved in the CTLA4Ig-DLI group (p = 0.001). The recovery of CD56dimNK cells, NKG2A-KIR + NK subsets and Tregs was significantly better in the CTLA4Ig-DLI group at all time points and memory T cells at day +90. Immune recovery in relation to DP showed distinct patterns, with T cell subsets in the DLI group and NKG2A-KIR+NK cells in CTLA4Ig-DLI group having favorable impact. CTLA4Ig-DLI was thus associated with an improved outcome, possibly on account of the distinct pattern of immune recovery shown with this novel approach.
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Jaiswal SR, Bhakuni P, Aiyer HM, Soni M, Bansal S, Chakrabarti S. CTLA4Ig in an Extended Schedule along with Sirolimus Improves Outcome with a Distinct Pattern of Immune Reconstitution Following Post-Transplantation Cyclophosphamide-Based Haploidentical Transplantation for Hemoglobinopathies. Biol Blood Marrow Transplant 2020; 26:1469-1476. [PMID: 32428732 DOI: 10.1016/j.bbmt.2020.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 01/24/2023]
Abstract
The major hindrances to the success of a haploidentical hematopoietic cell transplantation for hemoglobinopathies are graft failure, early post-transplant hemophagocytic syndrome (PTHPS), and graft-versus-host disease (GVHD). Following the successful incorporation of CTLA4Ig (abatacept) in post-transplantation cyclophosphamide-based haploidentical transplantation, we piloted this approach in 10 patients (aged 3 to 19 years), with thalassemia major (TM, n=5) and sickle cell disease (n = 5). Pretransplant immunosuppressive therapy (pTIST) was administered for 10 weeks. Conditioning was myeloablative. CTLA4Ig was administered every 2 weeks during pTIST and on days -1, +5, +20, and +35 and every 4 weeks thereafter for 6 months, along with sirolimus. A short course of low-dose dexamethasone was given from day +6 for 14 days. Nine patients engrafted at a median of 15 days, with 1 patient with TM dying of sepsis on day +19. None of the patients developed acute or chronic GVHD. All 9 patients are alive and disease free at a median follow-up of 28 months. Only 4 patients had cytomegalovirus reactivation. The pattern of immune reconstitution showed a prompt and sustained recovery of T cell subsets with memory phenotype, along with early and sustained increase of Tregs and NKG2C+ natural killer (NK) cells. This novel approach, targeting CD80 and CD86 on monocytes/macrophages, promoted engraftment and limited early-onset PTHPS and graft failure. The lack of GVHD and serious infections with this approach reflects an early recovery of Tregs, memory T cells, and persistence of NKG2C+ NK cells.
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Affiliation(s)
- Sarita Rani Jaiswal
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India.
| | - Prakash Bhakuni
- Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Hema Malini Aiyer
- Department of Anatomic Pathology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Mayank Soni
- Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Satish Bansal
- Department of Radiology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Suparno Chakrabarti
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
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8
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Limiting the Impact of Methicillin-Resistant Staphylococcus Aureus in Patients Undergoing Haploidentical Transplantation. Mediterr J Hematol Infect Dis 2020; 12:e2020024. [PMID: 32395213 PMCID: PMC7202342 DOI: 10.4084/mjhid.2020.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/04/2020] [Indexed: 11/10/2022] Open
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Impact of extended infusional mesna prophylaxis on the incidence of BK viruria and hemorrhagic cystitis following post-transplantation cyclophosphamide and CTLA4Ig-based haploidentical transplantation. Ann Hematol 2020; 99:839-845. [PMID: 32025839 DOI: 10.1007/s00277-020-03930-w] [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: 07/22/2019] [Accepted: 01/18/2020] [Indexed: 12/19/2022]
Abstract
Hemorrhagic cystitis (HC) has been reported with increased frequency following post-transplantation cyclophosphamide (PTCy)-based haploidentical hematopoietic cell transplantation (HCT) along with a strong association with BK viruria. We prospectively evaluated the incidence of BK viruria and HC in 115 patients (median age 20 years, 2-65) undergoing PTCy-based haploidentical HCT with (n = 71) or without (n = 44) CTLA4Ig. HC prophylaxis consisted of a continuous infusion of mesna 30 min prior and 48 h post-PTCy. The overall incidence of BK viruria was 65.7%. None with BK viruria < 104 copies/ml developed clinical symptoms (n = 65). The incidence of BK viruria ≥ 104 copies/ml was 7.1% (n = 8) and 75% developed HC. The incidence of HC was 5.4% at a median of 30 days. Both BK viruria ≥ 104 copies/ml and HC were strongly associated with acute GVHD (p < 0.001). A higher NRM was observed in those with BK viruria ≥ 104 copies/ml, related to GVHD and its complications (41.7% vs 12.6%, p = 0.04). The incidences of acute GVHD, vis-à-vis, overall BK viruria, BK viruria ≥ 104 copies/ml, and HC, tended to be lower in patients receiving CTLA4Ig. Thus, extended infusional mesna, coupled with significant reduction in alloreactivity along with possible preservation of antiviral immunity associated with the use of CTLA4Ig, was probably responsible for a much lower incidence of BK viruria and resultant HC than reported previously following PTCy-based haploidentical HCT.
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Jaiswal SR, Chakrabarti S. CTLA4Ig Limits Both Incidence and Severity of Early Cytokine Release Syndrome following Haploidentical Peripheral Blood Stem Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:e86-e87. [PMID: 31911258 DOI: 10.1016/j.bbmt.2019.12.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 12/20/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Sarita Rani Jaiswal
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; Department of Blood and Marrow Transplantation and Hematology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India.
| | - Suparno Chakrabarti
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; Department of Blood and Marrow Transplantation and Hematology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India
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Alterations in NKG2A and NKG2C Subsets of Natural Killer Cells Following Epstein–Barr Virus Reactivation in CTLA4Ig-based Haploidentical Transplantation Is Associated With Increased Chronic Graft-Versus-Host Disease. Transplantation 2020; 104:e23-e30. [DOI: 10.1097/tp.0000000000002941] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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12
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Implications of NKG2A in EBV Reactivation and Chronic Graft Versus Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation. Transplantation 2020; 104:e1-e2. [DOI: 10.1097/tp.0000000000002942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jaiswal SR, Chakrabarti S. Natural killer cell-based immunotherapy with CTLA4Ig-primed donor lymphocytes following haploidentical transplantation. Immunotherapy 2019; 11:1221-1230. [DOI: 10.2217/imt-2019-0037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
NK cell-based immunotherapy is one of the more exciting propositions in the field of cellular therapy for hematological malignancies. Current protocols are largely based on expanded and activated NK cells which are used both with and without allogeneic transplantation. Based on our recent findings, we discuss the concept of CTLA4Ig-primed donor lymphocyte infusions following haploidentical transplantation as an effective tool to garner NK cell-mediated antitumor effect with abrogation of T cell-mediated alloreactivity. This approach might widen the possibility of immunotherapy following haploidentical transplantation without increase in graft-versus-host disease. Further studies would be needed to establish the veracity of this concept with better understanding of the antitumor effect via this pathway. Future studies would decide if CTLA4Ig might be used to augment NK-cell activation in vitro as well.
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Affiliation(s)
- Sarita Rani Jaiswal
- Cellular Therapy & Immunology, Manashi Chakrabarti Foundation, Kolkata
- Department of Blood & Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital & Research Centre, New Delhi, India
| | - Suparno Chakrabarti
- Cellular Therapy & Immunology, Manashi Chakrabarti Foundation, Kolkata
- Department of Blood & Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital & Research Centre, New Delhi, India
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CTLA4Ig-based reduced intensity conditioning and donor lymphocyte infusions for haploidentical transplantation in refractory aggressive B-cell lymphoma relapsing after an autograft: Early results from a pilot study. Exp Hematol 2019; 77:26-35.e1. [DOI: 10.1016/j.exphem.2019.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/24/2019] [Accepted: 08/14/2019] [Indexed: 12/15/2022]
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Jaiswal SR, Bhakuni P, Bhagwati G, Joy A, Chakrabarti A, Chakrabarti S. Impact of Preemptive Granulocyte Infusions During Febrile Neutropenia in Patients Colonized with Carbapenem-Resistant Gram-Negative Bacteria Undergoing Haploidentical Transplantation. Biol Blood Marrow Transplant 2019; 25:1621-1628. [DOI: 10.1016/j.bbmt.2019.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/24/2019] [Accepted: 04/24/2019] [Indexed: 12/16/2022]
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16
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Jaiswal SR, Bhakuni P, Chakrabarti A, Chakrabarti S. Rotavirus infection following post‐transplantation cyclophosphamide based haploidentical hematopoietic cell transplantation in children is associated with hemophagocytic syndrome and high mortality. Transpl Infect Dis 2019; 21:e13136. [DOI: 10.1111/tid.13136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/17/2019] [Accepted: 06/22/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Sarita Rani Jaiswal
- Cellular Therapy and Immunology Manashi Chakrabarti Foundation Kolkata India
- Department of Blood and Marrow Transplantation Dharamshila Narayana Superspeciality Hospital and Research Centre New Delhi India
| | - Prakash Bhakuni
- Cellular Therapy and Immunology Manashi Chakrabarti Foundation Kolkata India
- Department of Blood and Marrow Transplantation Dharamshila Narayana Superspeciality Hospital and Research Centre New Delhi India
| | - Aditi Chakrabarti
- Cellular Therapy and Immunology Manashi Chakrabarti Foundation Kolkata India
| | - Suparno Chakrabarti
- Cellular Therapy and Immunology Manashi Chakrabarti Foundation Kolkata India
- Department of Blood and Marrow Transplantation Dharamshila Narayana Superspeciality Hospital and Research Centre New Delhi India
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Jaiswal SR, Bhakuni P, Bansal S, Aiyer HM, Bhargava S, Chakrabarti S. Targeting CD28-CD86 Pathway for Refractory Myeloma Through CTLA4Ig-Based Reduced-Intensity Conditioning and Donor Lymphocyte Infusions After Haploidentical Transplantation. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:e430-e435. [PMID: 31129111 DOI: 10.1016/j.clml.2019.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/02/2019] [Accepted: 04/19/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Sarita Rani Jaiswal
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India.
| | - Prakash Bhakuni
- Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Satish Bansal
- Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Hema Malini Aiyer
- Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Sneh Bhargava
- Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
| | - Suparno Chakrabarti
- Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India; Department of Blood and Marrow Transplantation, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
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Pan J, Niu Q, Deng B, Liu S, Wu T, Gao Z, Liu Z, Zhang Y, Qu X, Zhang Y, Liu S, Ling Z, Lin Y, Zhao Y, Song Y, Tan X, Zhang Y, Li Z, Yin Z, Chen B, Yu X, Yan J, Zheng Q, Zhou X, Gao J, Chang AH, Feng X, Tong C. CD22 CAR T-cell therapy in refractory or relapsed B acute lymphoblastic leukemia. Leukemia 2019; 33:2854-2866. [PMID: 31110217 DOI: 10.1038/s41375-019-0488-7] [Citation(s) in RCA: 145] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/05/2019] [Accepted: 04/08/2019] [Indexed: 01/08/2023]
Abstract
Despite worldwide promising clinical outcome of CD19 CAR-T therapy, relapse after this therapy is associated with poor prognosis and has become an urgent problem to be solved. We conducted a CD22 CAR T-cell therapy in 34 relapsed or refractory (r/r) B-ALL pediatric and adult patients who failed from previous CD19 CAR T-cell therapy. Complete remission (CR) or CR with incomplete count recovery (CRi) was achieved in 24 of 30 patients (80%) that could be evaluated on day 30 after infusion, which accounted for 70.5% of all 34 enrolled patients. Most patients only experienced mild cytokine-release syndrome and neurotoxicity. Seven CR patients received no further treatment, and 3 of them remained in remission at 6, 6.6, and 14 months after infusion. Eleven CR patients were promptly bridged to transplantation, and 8 of them remained in remission at 4.6 to 13.3 months after transplantation, resulted in 1-year leukemia-free survival rate of 71.6% (95% CI, 44.2-99.0). CD22 antigen loss or mutation was not observed to be associated with relapsed patients. Our study demonstrated that our CD22 CAR T-cells was highly effective in inducing remission in r/r B-ALL patients, and also provided a precious window for subsequent transplantation to achieve durable remission.
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Affiliation(s)
- Jing Pan
- Department of Hematology, Beijing Boren Hospital, Beijing, 100070, China
| | - Qing Niu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Hematological disorders, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - Biping Deng
- Cytology Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Shuangyou Liu
- Department of Hematology, Beijing Boren Hospital, Beijing, 100070, China
| | - Tong Wu
- Department of Bone Marrow Transplantation, Beijing Boren Hospital, Beijing, 100070, China
| | - Zhiyong Gao
- Department of Bone Marrow Transplantation, Beijing Boren Hospital, Beijing, 100070, China
| | - Zhaoli Liu
- Cytology Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Yue Zhang
- Cytology Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Xiaomin Qu
- Cytology Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Yanlei Zhang
- Clinical Translational Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Shaohui Liu
- Clinical Translational Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Zhuojun Ling
- Department of Hematology, Beijing Boren Hospital, Beijing, 100070, China
| | - Yuehui Lin
- Department of Hematology, Beijing Boren Hospital, Beijing, 100070, China
| | - Yongqiang Zhao
- Department of Bone Marrow Transplantation, Beijing Boren Hospital, Beijing, 100070, China
| | - Yanzhi Song
- Department of Bone Marrow Transplantation, Beijing Boren Hospital, Beijing, 100070, China
| | - Xiyou Tan
- Department of Bone Marrow Transplantation, Beijing Boren Hospital, Beijing, 100070, China
| | - Yan Zhang
- Department of Bone Marrow Transplantation, Beijing Boren Hospital, Beijing, 100070, China
| | - Zhihui Li
- Cytology Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Zhichao Yin
- Department of Hematology, Beijing Boren Hospital, Beijing, 100070, China
| | - Bingzhen Chen
- Medical Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Xinjian Yu
- Medical Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Ju Yan
- Medical Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Qinlong Zheng
- Medical Laboratory, Beijing Boren Hospital, Beijing, 100070, China
| | - Xuan Zhou
- Gaobo Healthcare Group, Beijing, China
| | - Jin Gao
- Gaobo Healthcare Group, Beijing, China
| | - Alex H Chang
- Clinical Translational Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China.
| | - Xiaoming Feng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Hematological disorders, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China. .,Central Laboratory, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
| | - Chunrong Tong
- Department of Hematology, Beijing Boren Hospital, Beijing, 100070, China.
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19
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Jaiswal SR, Bhakuni P, Bhagawati G, Chakrabarti A, Chakrabarti S. CTLA4Ig-based T-cell costimulation blockade is associated with reduction of adenovirus viremia following post-transplantation cyclophosphamide-based haploidentical transplantation. Bone Marrow Transplant 2019; 55:649-652. [DOI: 10.1038/s41409-019-0549-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 02/26/2019] [Accepted: 04/12/2019] [Indexed: 11/09/2022]
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