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Louault K, De Clerck YA, Janoueix-Lerosey I. The neuroblastoma tumor microenvironment: From an in-depth characterization towards novel therapies. EJC PAEDIATRIC ONCOLOGY 2024; 3:100161. [PMID: 39036648 PMCID: PMC11259008 DOI: 10.1016/j.ejcped.2024.100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Neuroblastoma is a cancer of the sympathetic nervous system that develops in young children, either as low-risk or high-risk disease. The tumor microenvironment (TME) is now recognized as an important player of the tumor ecosystem that may promote drug resistance and immune escape. Targeting the TME in combination with therapies directly targeting tumor cells therefore represents an interesting strategy to prevent the emergence of resistance in cancer and improve patient's outcome. The development of such strategies however requires an in-depth understanding of the TME landscape, due to its high complexity and intra and inter-tumoral heterogeneity. Various approaches have been used in the last years to characterize the immune and non-immune cell populations present in tumors of neuroblastoma patients, both quantitatively and qualitatively, in particular with the use of single-cell transcriptomics. It is anticipated that in the near future, both genomic and TME information in tumors will contribute to a precise approach to therapy in neuroblastoma. Deciphering the mechanisms of interaction between neuroblastoma cells and stromal or immune cells in the TME is key to identify novel therapeutic combinations. Over the last decade, numerous in vitro studies and in vivo pre-clinical experiments in immune-competent and immune-deficient models have identified therapeutic approaches to circumvent drug resistance and immune escape. Some of these studies have formed the basis for early phase I and II clinical trials in children with recurrent and refractory high-risk neuroblastoma. This review summarizes recently published data on the characterization of the TME landscape in neuroblastoma and novel strategies targeting various TME cellular components, molecules and pathways activated as a result of the tumor-host interactions.
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Affiliation(s)
- Kevin Louault
- Children’s Hospital Los Angeles, Cancer, and Blood Disease Institute, 4650 Sunset Bld., Los Angeles, CA, USA
| | - Yves A. De Clerck
- Children’s Hospital Los Angeles, Cancer, and Blood Disease Institute, 4650 Sunset Bld., Los Angeles, CA, USA
- Department of Pediatrics and Biochemistry and Molecular Medicine, University of Southern California, CA, USA
| | - Isabelle Janoueix-Lerosey
- Curie Institute, PSL Research University, Inserm U830, Paris, France
- SIREDO: Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer, Curie Institute, Paris, France
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Ahn WK, Nam HJ, Lee HW, Hahn S, Han JW, Lyu CJ, Kim S, Kwon SS, Chung H, Kim JS, Cheong JW, Lee KA. Poor Mobilization-Associated Factors in Autologous Hematopoietic Stem Cell Harvest. Cancers (Basel) 2024; 16:1821. [PMID: 38791900 PMCID: PMC11120230 DOI: 10.3390/cancers16101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Peripheral blood stem cell transplantation (PBSCT) is an important therapeutic measure for both hematologic and non-hematologic diseases. For PBSCT to be successful, sufficient CD34+ cells need to be mobilized and harvested. Although risk factors associated with poor mobilization in patients with hematologic diseases have been reported, studies of patients with non-hematologic diseases and those receiving plerixafor are rare. To identify factors associated with poor mobilization, data from autologous PBSC harvest (PBSCH) in 491 patients were retrospectively collected and analyzed. A multivariate analysis revealed that in patients with a hematologic disease, an age older than 60 years (odds ratio [OR] 1.655, 95% confidence interval [CI] 1.049-2.611, p = 0.008), the use of myelotoxic agents (OR 4.384, 95% CI 2.681-7.168, p < 0.001), and a low platelet count (OR 2.106, 95% CI 1.205-3.682, p = 0.009) were associated with poor mobilization. In patients with non-hematologic diseases, a history of radiation on the pelvis/spine was the sole associated factor (OR 12.200, 95% CI 1.934-76.956, p = 0.008). Among the group of patients who received plerixafor, poor mobilization was observed in 19 patients (19/134, 14.2%) and a difference in the mobilization regimen was noted among the good mobilization group. These results show that the risk factors for poor mobilization in patients with non-hematologic diseases and those receiving plerixafor differ from those in patients with hematologic diseases; as such, non-hematologic patients require special consideration to enable successful PBSCH.
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Affiliation(s)
- Won Kee Ahn
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Republic of Korea
| | - Hyun-Jun Nam
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hae Won Lee
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Republic of Korea
| | - Seungmin Hahn
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Republic of Korea
| | - Jung Woo Han
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Republic of Korea
| | - Chuhl Joo Lyu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Republic of Korea
| | - Sinyoung Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Soon Sung Kwon
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Haerim Chung
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - June-Won Cheong
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Kyung-A Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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Iriondo J, Zubicaray J, Sebastián E, González de Pablo J, González-Vicent M, Molina B, López-Torija I, Castillo A, Ramírez M, Madero L, Díaz MÁ, Sevilla J. Mobilization with high-dose granulocyte colony-stimulating factor alone at 12 μg/kg twice a day in high-risk pediatric patients: A retrospective analysis of the experience in a single center. J Clin Apher 2022; 37:420-429. [PMID: 35662241 DOI: 10.1002/jca.21994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/15/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Mobilization regimes in pediatric patients at high risk for poor mobilization are not standardized across different institutions. We present a retrospective analysis of our experience with a high-dose granulocyte colony-stimulating factor (G-CSF) regime of 12 μg/Kg per body weight (BW) twice a day for 4 days used in high-risk patients. MATERIAL AND METHODS We report the results of all pediatric patients mobilized with high-dose G-CSF between January 1999 and February 2021 in our center. A successful mobilization was defined as a peripheral blood (PB) CD34+ cell count of ≥10 CD34+ cells/μl on the fifth day of mobilization immediately before leukapheresis. A minimum cell yield of ≥2 × 106 CD34+ cells/Kg of BW was required for a successful collection. RESULTS Of the 262 patients included in the analysis, mobilization failure was found in 27 (10.3%). In a univariate analysis, this was associated with age, weight, baseline diagnosis, and having undergone a previous mobilization cycle, the latter being the only factor that remained significantly associated in a multivariate analysis (P = 0.03). The 54 patients (20.6%) did not reach the minimum required CD34+ cell yield. 50.4% of the patients reported adverse events (AEs) during the mobilization period, and 23 (9.1%) reported 3 or more concomitant AEs. However, all of them were mild and did not affect the mobilization schedule. CONCLUSIONS Although most high-risk pediatric patients are successfully mobilized with the high-dose G-CSF regime, this approach does not salvage all of them and significantly increases the presence of AEs in comparison to standard-dose regimes.
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Affiliation(s)
- June Iriondo
- Hematology and Hemotherapy Unit, Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain
| | - Josune Zubicaray
- Hematology and Hemotherapy Unit, Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain
| | - Elena Sebastián
- Hematology and Hemotherapy Unit, Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain
| | - Jesús González de Pablo
- Hematology and Hemotherapy Unit, Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain
| | - Marta González-Vicent
- Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain.,Hematopoietic Stem Cell Transplantation Unit, Pediatric Hematology and Oncology department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Blanca Molina
- Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain.,Hematopoietic Stem Cell Transplantation Unit, Pediatric Hematology and Oncology department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Ivan López-Torija
- Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain.,Hematopoietic Stem Cell Transplantation Unit, Pediatric Hematology and Oncology department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Ana Castillo
- Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain.,Hematology and Oncology Laboratory Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Manuel Ramírez
- Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain.,Hematology and Oncology Laboratory Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Luis Madero
- Hematology and Hemotherapy Unit, Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain.,Hematopoietic Stem Cell Transplantation Unit, Pediatric Hematology and Oncology department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Hematology and Oncology Laboratory Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Miguel Ángel Díaz
- Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain.,Hematopoietic Stem Cell Transplantation Unit, Pediatric Hematology and Oncology department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Julián Sevilla
- Hematology and Hemotherapy Unit, Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,Fundación para la Investigación Biomédica Hospital Infantil Universitario, Niño Jesús, Madrid, Spain
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Hematopoietic Stem Cell Gene-Addition/Editing Therapy in Sickle Cell Disease. Cells 2022; 11:cells11111843. [PMID: 35681538 PMCID: PMC9180595 DOI: 10.3390/cells11111843] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/29/2022] [Accepted: 06/02/2022] [Indexed: 12/17/2022] Open
Abstract
Autologous hematopoietic stem cell (HSC)-targeted gene therapy provides a one-time cure for various genetic diseases including sickle cell disease (SCD) and β-thalassemia. SCD is caused by a point mutation (20A > T) in the β-globin gene. Since SCD is the most common single-gene disorder, curing SCD is a primary goal in HSC gene therapy. β-thalassemia results from either the absence or the reduction of β-globin expression, and it can be cured using similar strategies. In HSC gene-addition therapy, patient CD34+ HSCs are genetically modified by adding a therapeutic β-globin gene with lentiviral transduction, followed by autologous transplantation. Alternatively, novel gene-editing therapies allow for the correction of the mutated β-globin gene, instead of addition. Furthermore, these diseases can be cured by γ-globin induction based on gene addition/editing in HSCs. In this review, we discuss HSC-targeted gene therapy in SCD with gene addition as well as gene editing.
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