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Shi Q, Wu C, Han W, Zhao S, Wu Y, Jin Y, Qu X, Li J, Zhang R, Chen L. Clinical significance of CD200 expression in newly diagnosed multiple myeloma patients and dynamic changing during treatment. Leuk Lymphoma 2020; 62:709-715. [PMID: 33108911 DOI: 10.1080/10428194.2020.1839653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of our study was to determine the impact of CD200 expression in newly diagnosed myltiple myeloma (MM) patients. CD200+ patients had significantly shorter median overall survival time (OS) than CD200- patients (41.0 months vs. not reached, p = .009). The ratio of CD4+ to CD8+ T cells was lower in CD200+ patients and this reduction was significantly related to the increase of CD8+ T cells (p = .021). Moreover, we analyzed dynamic changes of CD200 expression in 47 CD200+ patients during treatment. Thirty-eight (80.9%) patients switched to CD200- during treatment. Those patients had a favorable survival compared with the others (median OS, 65.0 vs. 32.0 months, p < .001; median PFS, 29.0 vs. 11.5 months, p = .027). We concluded that CD200 expression is an independent marker for MM prognostic estimation during treatment.
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Affiliation(s)
- Qinglin Shi
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Chao Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Wenmin Han
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Sishu Zhao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yujie Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yuanyuan Jin
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Xiaoyan Qu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Jianyong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Run Zhang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Lijuan Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
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2
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Lucas F, Pennell M, Huang Y, Benson DM, Efebera YA, Chaudhry M, Hughes T, Woyach JA, Byrd JC, Zhang S, Jones D, Guan X, Burd CE, Rosko AE. T Cell Transcriptional Profiling and Immunophenotyping Uncover LAG3 as a Potential Significant Target of Immune Modulation in Multiple Myeloma. Biol Blood Marrow Transplant 2019; 26:7-15. [PMID: 31445183 DOI: 10.1016/j.bbmt.2019.08.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/16/2019] [Accepted: 08/11/2019] [Indexed: 12/20/2022]
Abstract
Autologous stem cell transplant (ASCT) is the standard of care for patients with multiple myeloma (MM). The clinical significance of peripheral blood T lymphocyte (PBTL) immunologic changes associated with ASCT is poorly understood. Here we evaluated T cell transcriptional messenger RNA profiles and immunophenotypes to correlate immunologic senescence, exhaustion, and anergy with clinical endpoints in a cohort of patients with MM undergoing ASCT. ASCT induced global transcriptional T cell changes and altered molecular levels of markers of T cell subtypes, T cell activation, and exhaustion. These included reduced CD4/CD8 ratio, skewing toward the Th1 subset, reduced expression of costimulatory receptors CD27 and CD28, heightened T cell activation, and increased expression of immune modulatory molecules LAG3 and PD1. Multicolor flow cytometry experiments confirmed altered circulating CD4 and CD8 subsets and skewing toward differentiated effector cells. Moreover, ASCT promoted an exhausted immunophenotype in CD3+CD4+ subsets and a senescent immunophenotype in CD3+CD8+ subsets. Subset-specific altered expression was also seen for surface molecules with immunomodulatory function. ASCT affected soluble levels of molecules with immunomodulatory function by increasing plasma HVEM and TIM3. High molecular LAG3 level was associated with inferior event-free survival post-ASCT (hazard ratio = 5.44; confidence interval, 1.92 to 15.46; P = .001; adjusted P [controlling for false discovery rate] = .038). Using a comprehensive evaluation of PBTLs on a molecular and phenotypic level, we have identified that ASCT induces global T cell alterations with CD4 and CD8 subset-specific changes. Moreover, LAG3 emerged as an early biomarker of adverse events post-ASCT. These findings will support the development of treatment strategies targeting immune defects in MM to augment or restore T cell responses.
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Affiliation(s)
- Fabienne Lucas
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Michael Pennell
- College of Public Health, Division of Biostatistics, The Ohio State University, Columbus, Ohio
| | - Ying Huang
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Don M Benson
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Yvonne A Efebera
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Maria Chaudhry
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Tiffany Hughes
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | | | - John C Byrd
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Suohui Zhang
- Department of Molecular Genetics, Cancer Biology and Genetics, The Ohio State University, Columbus, Ohio
| | - Desiree Jones
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Xiangnan Guan
- Department of Molecular Genetics, Cancer Biology and Genetics, The Ohio State University, Columbus, Ohio
| | - Christin E Burd
- Department of Molecular Genetics, Cancer Biology and Genetics, The Ohio State University, Columbus, Ohio
| | - Ashley E Rosko
- Division of Hematology, The Ohio State University, Columbus, Ohio.
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3
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Hidalgo-Lopez JE, Higa MG, Ferrian S, Lin P, Blando J, Medeiros LJ, Bueso-Ramos CE. Levels of CD8+ tumor infiltrating lymphocytes correlate with disease burden in bone marrow of therapy Naïve multiple myeloma patients. Ann Diagn Pathol 2018; 40:174-175. [PMID: 30509755 DOI: 10.1016/j.anndiagpath.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Juliana E Hidalgo-Lopez
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States of America
| | - Maria Gisela Higa
- Department of Immunology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States of America
| | - Selena Ferrian
- Department of Immunology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States of America
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States of America
| | - Jorge Blando
- Department of Immunology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States of America
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States of America
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States of America.
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4
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Tan J, Chen S, Huang J, Chen Y, Yang L, Wang C, Zhong J, Lu Y, Wang L, Zhu K, Li Y. Increased exhausted CD8+T cells with programmed death-1, T-cell immunoglobulin and mucin-domain-containing-3 phenotype in patients with multiple myeloma. Asia Pac J Clin Oncol 2018; 14:e266-e274. [PMID: 29943497 DOI: 10.1111/ajco.13033] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 05/29/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Jiaxiong Tan
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Shaohua Chen
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Jingying Huang
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Youchun Chen
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Lijian Yang
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Chunli Wang
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Jun Zhong
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Yuhong Lu
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Liang Wang
- Department of Oncology; First Affiliated Hospital; Jinan University; Guangzhou China
| | - Kanger Zhu
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
| | - Yangqiu Li
- Department of Hematology; First Affiliated Hospital; Institute of Hematology, School of Medicine, Key Laboratory for Regenerative Medicine of Ministry of Education; Jinan University; Guangzhou China
- Guangdong Province Key Laboratory of Molecular Immunology and Antibody Engineering; Jinan University; Guangzhou China
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5
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Franssen LE, Roeven MWH, Hobo W, Doorn R, Oostvogels R, Falkenburg JHF, van de Donk NW, Kester MGD, Fredrix H, Westinga K, Slaper-Cortenbach I, Spierings E, Kersten MJ, Dolstra H, Mutis T, Schaap N, Lokhorst HM. A phase I/II minor histocompatibility antigen-loaded dendritic cell vaccination trial to safely improve the efficacy of donor lymphocyte infusions in myeloma. Bone Marrow Transplant 2017; 52:1378-1383. [PMID: 28581468 DOI: 10.1038/bmt.2017.118] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/15/2017] [Accepted: 04/20/2017] [Indexed: 12/22/2022]
Abstract
Allogeneic stem cell transplantation (allo-SCT) with or without donor lymphocyte infusions (DLI) is the only curative option for several hematological malignancies. Unfortunately, allo-SCT is often associated with GvHD, and patients often relapse. We therefore aim to improve the graft-versus-tumor effect, without increasing the risk of GvHD, by targeting hematopoietic lineage-restricted and tumor-associated minor histocompatibility antigens using peptide-loaded dendritic cell (DC) vaccinations. In the present multicenter study, we report the feasibility, safety and efficacy of this concept. We treated nine multiple myeloma patients with persistent or relapsed disease after allo-SCT and a previous DLI, with donor monocyte-derived mHag-peptide-loaded DC vaccinations combined with a second DLI. Vaccinations were well tolerated and no occurrence of GvHD was observed. In five out of nine patients, we were able to show the induction of mHag-specific CD8+ T cells in peripheral blood. Five out of nine patients, of which four developed mHag-specific T cells, showed stable disease (SD) for 3.5-10 months. This study shows that mHag-based donor monocyte-derived DC vaccination combined with DLI is safe, feasible and capable of inducing objective mHag-specific T-cell responses. Future research should focus on further improvement of the vaccination strategy, toward translating the observed T-cell responses into robust clinical responses.
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Affiliation(s)
- L E Franssen
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - M W H Roeven
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - W Hobo
- Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R Doorn
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Oostvogels
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - J H F Falkenburg
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - N W van de Donk
- Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - M G D Kester
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - H Fredrix
- Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K Westinga
- Cell Therapy Facility, University Medical Center Utrecht, Utrecht, The Netherlands
| | - I Slaper-Cortenbach
- Cell Therapy Facility, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Spierings
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M J Kersten
- Department of Hematology, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - H Dolstra
- Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T Mutis
- Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - N Schaap
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H M Lokhorst
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
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6
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Zelle-Rieser C, Thangavadivel S, Biedermann R, Brunner A, Stoitzner P, Willenbacher E, Greil R, Jöhrer K. T cells in multiple myeloma display features of exhaustion and senescence at the tumor site. J Hematol Oncol 2016; 9:116. [PMID: 27809856 PMCID: PMC5093947 DOI: 10.1186/s13045-016-0345-3] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/18/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple myeloma is an incurable plasma cell malignancy that is mostly restricted to the bone marrow. Cancer-induced dysfunction of cytotoxic T cells at the tumor site may be responsible for immune evasion and therapeutical failure of immunotherapies. Therefore, enhanced knowledge about the actual status of T cells in myeloma bone marrow is urgently needed. Here, we assessed the expression of inhibitory molecules PD-1, CTLA-4, 2B4, CD160, senescence marker CD57, and CD28 on T cells of naive and treated myeloma patients in the bone marrow and peripheral blood and collected data on T cell subset distribution in both compartments. In addition, T cell function concerning proliferation and expression of T-bet, IL-2, IFNγ, and CD107a was investigated after in vitro stimulation by CD3/CD28. Finally, data was compared to healthy, age-matched donor T cells from both compartments. METHODS Multicolor flow cytometry was utilized for the analyses of surface molecules, intracellular staining of cytokines was also performed by flow cytometry, and proliferation was assessed by 3H-thymidine incorporation. Statistical analyses were performed utilizing unpaired T test and Mann-Whitney U test. RESULTS We observed enhanced T cell exhaustion and senescence especially at the tumor site. CD8+ T cells expressed several molecules associated with T cell exhaustion (PD-1, CTLA-4, 2B4, CD160) and T cell senescence (CD57, lack of CD28). This phenotype was associated with lower proliferative capacity and impaired function. Despite a high expression of the transcription factor T-bet, CD8+ T cells from the tumor site failed to produce IFNγ after CD3/CD28 in vitro restimulation and displayed a reduced ability to degranulate in response to T cell stimuli. Notably, the percentage of senescent CD57+CD28- CD8+ T cells was significantly lower in treated myeloma patients when compared to untreated patients. CONCLUSIONS T cells from the bone marrow of myeloma patients were more severely impaired than peripheral T cells. While our data suggest that terminally differentiated cells are preferentially deleted by therapy, immune-checkpoint molecules were still present on T cells supporting the potential of checkpoint inhibitors to reactivate T cells in myeloma patients in combination therapies. However, additional avenues to restore anti-myeloma T cell responses are urgently needed.
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Affiliation(s)
| | | | - Rainer Biedermann
- Department of Orthopedic Surgery, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Andrea Brunner
- Department of Pathology, Medical University of Innsbruck, Müllerstraße 44, Innsbruck, Austria
| | - Patrizia Stoitzner
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Ella Willenbacher
- Department of Internal Medicine V, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Richard Greil
- Tyrolean Cancer Research Institute, Innrain 66, 6020, Innsbruck, Austria.,Salzburg Cancer Research Institute (SCRI), Müllner Hauptstraße 48, 5020, Salzburg, Austria.,Third Medical Department at The Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, Salzburg, Austria
| | - Karin Jöhrer
- Tyrolean Cancer Research Institute, Innrain 66, 6020, Innsbruck, Austria.
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7
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Willenbacher W, Thangavadivel S, Greil R, Willenbacher E, Weger R, Manzl C, Jöhrer K, Brunner A. Low Beclin-1 expression predicts improved overall survival in patients treated with immunomodulatory drugs for multiple myeloma and identifies autophagy inhibition as a promising potentially druggable new therapeutic target: an analysis from The Austrian Myeloma Registry (AMR). Leuk Lymphoma 2016; 57:2330-41. [DOI: 10.3109/10428194.2016.1144880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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