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Cai B, Guo M, Wang Y, Zhang Y, Yang J, Guo Y, Dai H, Yu C, Sun Q, Qiao J, Hu K, Zuo H, Dong Z, Zhang Z, Feng M, Li B, Sun Y, Liu T, Liu Z, Wang Y, Huang Y, Yao B, Han W, Ai H. Co-infusion of haplo-identical CD19-chimeric antigen receptor T cells and stem cells achieved full donor engraftment in refractory acute lymphoblastic leukemia. J Hematol Oncol 2016; 9:131. [PMID: 27887660 PMCID: PMC5124292 DOI: 10.1186/s13045-016-0357-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/10/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Elderly patients with relapsed and refractory acute lymphoblastic leukemia (ALL) have poor prognosis. Autologous CD19 chimeric antigen receptor-modified T (CAR-T) cells have potentials to cure patients with B cell ALL; however, safety and efficacy of allogeneic CD19 CAR-T cells are still undetermined. CASE PRESENTATION We treated a 71-year-old female with relapsed and refractory ALL who received co-infusion of haplo-identical donor-derived CD19-directed CAR-T cells and mobilized peripheral blood stem cells (PBSC) following induction chemotherapy. Undetectable minimal residual disease by flow cytometry was achieved, and full donor cell engraftment was established. The transient release of cytokines and mild fever were detected. Significantly elevated serum lactate dehydrogenase, alanine transaminase, bilirubin and glutamic-oxalacetic transaminase were observed from days 14 to 18, all of which were reversible after immunosuppressive therapy. CONCLUSIONS Our preliminary results suggest that co-infusion of haplo-identical donor-derived CAR-T cells and mobilized PBSCs may induce full donor engraftment in relapsed and refractory ALL including elderly patients, but complications related to donor cell infusions should still be cautioned. TRIAL REGISTRATION Allogeneic CART-19 for Elderly Relapsed/Refractory CD19+ ALL. NCT02799550.
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Affiliation(s)
- Bo Cai
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Mei Guo
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Yao Wang
- Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yajing Zhang
- Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Jun Yang
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Yelei Guo
- Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Hanren Dai
- Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Changlin Yu
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Qiyun Sun
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Jianhui Qiao
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Kaixun Hu
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Hongli Zuo
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Zheng Dong
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Zechuan Zhang
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Mingxing Feng
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Bingxia Li
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Yujing Sun
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Tieqiang Liu
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Zhiqing Liu
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Yi Wang
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Yajing Huang
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Bo Yao
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China
| | - Weidong Han
- Department of Immunology/Department of Bio-therapeutic, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Huisheng Ai
- Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Beijing, 100071, China.
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Brudno JN, Somerville RPT, Shi V, Rose JJ, Halverson DC, Fowler DH, Gea-Banacloche JC, Pavletic SZ, Hickstein DD, Lu TL, Feldman SA, Iwamoto AT, Kurlander R, Maric I, Goy A, Hansen BG, Wilder JS, Blacklock-Schuver B, Hakim FT, Rosenberg SA, Gress RE, Kochenderfer JN. Allogeneic T Cells That Express an Anti-CD19 Chimeric Antigen Receptor Induce Remissions of B-Cell Malignancies That Progress After Allogeneic Hematopoietic Stem-Cell Transplantation Without Causing Graft-Versus-Host Disease. J Clin Oncol 2016; 34:1112-21. [PMID: 26811520 PMCID: PMC4872017 DOI: 10.1200/jco.2015.64.5929] [Citation(s) in RCA: 451] [Impact Index Per Article: 56.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Progressive malignancy is the leading cause of death after allogeneic hematopoietic stem-cell transplantation (alloHSCT). After alloHSCT, B-cell malignancies often are treated with unmanipulated donor lymphocyte infusions (DLIs) from the transplant donor. DLIs frequently are not effective at eradicating malignancy and often cause graft-versus-host disease, a potentially lethal immune response against normal recipient tissues. METHODS We conducted a clinical trial of allogeneic T cells genetically engineered to express a chimeric antigen receptor (CAR) targeting the B-cell antigen CD19. Patients with B-cell malignancies that had progressed after alloHSCT received a single infusion of CAR T cells. No chemotherapy or other therapies were administered. The T cells were obtained from each recipient's alloHSCT donor. RESULTS Eight of 20 treated patients obtained remission, which included six complete remissions (CRs) and two partial remissions. The response rate was highest for acute lymphoblastic leukemia, with four of five patients obtaining minimal residual disease-negative CR. Responses also occurred in chronic lymphocytic leukemia and lymphoma. The longest ongoing CR was more than 30 months in a patient with chronic lymphocytic leukemia. New-onset acute graft-versus-host disease after CAR T-cell infusion developed in none of the patients. Toxicities included fever, tachycardia, and hypotension. Peak blood CAR T-cell levels were higher in patients who obtained remissions than in those who did not. Programmed cell death protein-1 expression was significantly elevated on CAR T cells after infusion. Presence of blood B cells before CAR T-cell infusion was associated with higher postinfusion CAR T-cell levels. CONCLUSION Allogeneic anti-CD19 CAR T cells can effectively treat B-cell malignancies that progress after alloHSCT. The findings point toward a future when antigen-specific T-cell therapies will play a central role in alloHSCT.
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MESH Headings
- Adult
- Aged
- Antigens, CD19/immunology
- Disease Progression
- Female
- Graft vs Host Disease/etiology
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Leukemia, B-Cell/immunology
- Leukemia, B-Cell/surgery
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/surgery
- Male
- Middle Aged
- Receptors, Antigen, T-Cell/metabolism
- Remission Induction
- T-Lymphocytes/immunology
- T-Lymphocytes/transplantation
- Transplantation Chimera
- Transplantation, Homologous
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Affiliation(s)
- Jennifer N Brudno
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Robert P T Somerville
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Victoria Shi
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Jeremy J Rose
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - David C Halverson
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Daniel H Fowler
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Juan C Gea-Banacloche
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Steven Z Pavletic
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Dennis D Hickstein
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Tangying L Lu
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Steven A Feldman
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Alexander T Iwamoto
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Roger Kurlander
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Irina Maric
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Andre Goy
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Brenna G Hansen
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Jennifer S Wilder
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Bazetta Blacklock-Schuver
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Frances T Hakim
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Steven A Rosenberg
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Ronald E Gress
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - James N Kochenderfer
- Jennifer N. Brudno, Robert P.T. Somerville, Victoria Shi, Jeremy J. Rose, David C. Halverson, Daniel H. Fowler, Juan C. Gea-Banacloche, Steven Z. Pavletic, Dennis D. Hickstein, Tangying L. Lu, Steven A. Feldman, Alexander T. Iwamoto, Brenna G. Hansen, Bazetta Blacklock-Schuver, Frances T. Hakim, Steven A. Rosenberg, Ronald E. Gress, and James N. Kochenderfer, National Cancer Institute; Roger Kurlander and Irina Maric, National Institutes of Health, Bethesda; Jennifer S. Wilder, Frederick National Laboratory for Cancer Research, Frederick, MD; and Andre Goy, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ.
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