1
|
Philippen L, Schub N, Günther A, Cario G, Schrappe M, Repp R, Gramatzki M. Alemtuzumab treatment for steroid-refractory acute graft-versus-host disease leads to severe immunosuppression but not to relapse of malignant disease. Bone Marrow Transplant 2024; 59:153-155. [PMID: 37932418 PMCID: PMC10781631 DOI: 10.1038/s41409-023-02144-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Lennart Philippen
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Natalie Schub
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Andreas Günther
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Gunnar Cario
- Department of Pediatrics, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Martin Schrappe
- Department of Pediatrics, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Roland Repp
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany.
| |
Collapse
|
2
|
Lutz S, Klausz K, Albici AM, Ebinger L, Sellmer L, Teipel H, Frenzel A, Langner A, Winterberg D, Krohn S, Hust M, Schirrmann T, Dübel S, Scherließ R, Humpe A, Gramatzki M, Kellner C, Peipp M. Novel NKG2D-directed bispecific antibodies enhance antibody-mediated killing of malignant B cells by NK cells and T cells. Front Immunol 2023; 14:1227572. [PMID: 37965326 PMCID: PMC10641740 DOI: 10.3389/fimmu.2023.1227572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
The activating receptor natural killer group 2, member D (NKG2D) represents an attractive target for immunotherapy as it exerts a crucial role in cancer immunosurveillance by regulating the activity of cytotoxic lymphocytes. In this study, a panel of novel NKG2D-specific single-chain fragments variable (scFv) were isolated from naïve human antibody gene libraries and fused to the fragment antigen binding (Fab) of rituximab to obtain [CD20×NKG2D] bibodies with the aim to recruit cytotoxic lymphocytes to lymphoma cells. All bispecific antibodies bound both antigens simultaneously. Two bibody constructs, [CD20×NKG2D#3] and [CD20×NKG2D#32], efficiently activated natural killer (NK) cells in co-cultures with CD20+ lymphoma cells. Both bibodies triggered NK cell-mediated lysis of lymphoma cells and especially enhanced antibody-dependent cell-mediated cytotoxicity (ADCC) by CD38 or CD19 specific monoclonal antibodies suggesting a synergistic effect between NKG2D and FcγRIIIA signaling pathways in NK cell activation. The [CD20×NKG2D] bibodies were not effective in redirecting CD8+ T cells as single agents, but enhanced cytotoxicity when combined with a bispecific [CD19×CD3] T cell engager, indicating that NKG2D signaling also supports CD3-mediated T cell activation. In conclusion, engagement of NKG2D with bispecific antibodies is attractive to directly activate cytotoxic lymphocytes or to support their activation by monoclonal antibodies or bispecific T cell engagers. As a perspective, co-targeting of two tumor antigens may allow fine-tuning of antibody cancer therapies. Our proposed combinatorial approach is potentially applicable for many existing immunotherapies but further testing in different preclinical models is necessary to explore the full potential.
Collapse
Affiliation(s)
- Sebastian Lutz
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, Ludwig Maximilians University (LMU) Munich, Munich, Germany
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Katja Klausz
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Anca-Maria Albici
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Lea Ebinger
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Lea Sellmer
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Hannah Teipel
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | | | - Anna Langner
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Dorothee Winterberg
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Steffen Krohn
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Michael Hust
- YUMAB GmbH, Braunschweig, Germany
- Technische Universität Braunschweig, Institut für Biochemie, Biotechnologie und Bioinformatik, Abteilung Biotechnologie, Braunschweig, Germany
| | | | - Stefan Dübel
- Technische Universität Braunschweig, Institut für Biochemie, Biotechnologie und Bioinformatik, Abteilung Biotechnologie, Braunschweig, Germany
| | - Regina Scherließ
- Department of Pharmaceutics and Biopharmaceutics, Kiel University, Kiel, Germany
| | - Andreas Humpe
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, Ludwig Maximilians University (LMU) Munich, Munich, Germany
| | - Martin Gramatzki
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| | - Christian Kellner
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, Ludwig Maximilians University (LMU) Munich, Munich, Germany
| | - Matthias Peipp
- Division of Antibody-Based Immunotherapy, Department of Medicine II, Kiel University, Kiel, Germany
| |
Collapse
|
3
|
Gramatzki D, Weiss T, Hänsch L, Silginer M, Rushing EJ, Roth P, Gramatzki M, Peipp M, Weller M. P10.19.B An immunotoxin targeting CD317 for the treatment of glioblastoma. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
CD317 is an interferon-inducible cell surface receptor expressed in several solid cancer types. HM1.24-ETA’ is a small immunotoxin with a CD317 single-chain variable fragment (svFv) antibody fused to a truncated version of Pseudomonas aeruginosa exotoxin A (ETA’) that is explored as a novel therapeutic approach in CD317-expressing tumors.
Material and Methods
CD317 mRNA expression in human gliomas and its association with survival was analyzed using the database of the Cancer Genome Atlas (TCGA). CD317 protein levels in human gliomas were assessed by immunohistochemistry. CD317 mRNA expression was assessed by RT-PCR and CD317 protein levels by flow cytometry in 13 human glioma cell lines in vitro. Efficacy of HM1.24-ETA’ was analyzed in acute cytotoxicity assays in vitro. Finally, HM1.24-ETA’ was evaluated in the intracranial human LN-229 glioma xenograft nude mouse model after intravenous injection.
Results
Interrogation of the TCGA database showed that increased CD317 mRNA expression correlated with grade of malignancy among isocitrate dehydrogenase (IDH) wildtype and IDH-mutant gliomas. Enhanced CD317 mRNA expression was associated with inferior survival in glioblastoma and astrocytoma, IDH-mutant, WHO grade 4. Immunohistochemistry confirmed CD317 overexpression in human glioblastoma compared to lower grade astrocytomas. CD317 was expressed heterogeneously on mRNA and protein levels in glioma cell lines in vitro. HM1.24-ETA’ induced acute cytotoxicity in CD317-positive glioma cells in vitro. CD317 expression and susceptibility to HM1.24-ETA’-induced cell death were enhanced by interferon-β. HM1.24-ETA’ prolonged survival in the LN-229 xenograft nude mouse model.
Conclusion
These data define CD317 as a novel target for treatment of human gliomas with immunoconjugates.
Collapse
Affiliation(s)
- D Gramatzki
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland
| | - T Weiss
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland
| | - L Hänsch
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland
| | - M Silginer
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland
| | - E J Rushing
- Department of Neuropathology, University Hospital Zurich , Zurich , Switzerland
| | - P Roth
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital of Schleswig-Holstein, Campus Kiel , Kiel , Germany
| | - M Peipp
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital of Schleswig-Holstein, Campus Kiel , Kiel , Germany
| | - M Weller
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland
| |
Collapse
|
4
|
Krohn S, Boje AS, Gehlert CL, Lutz S, Darzentas N, Knecht H, Herrmann D, Brüggemann M, Scheidig AJ, Weisel K, Gramatzki M, Peipp M, Klausz K. Identification of New Antibodies Targeting Malignant Plasma Cells for Immunotherapy by Next-Generation Sequencing-Assisted Phage Display. Front Immunol 2022; 13:908093. [PMID: 35784366 PMCID: PMC9248769 DOI: 10.3389/fimmu.2022.908093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/19/2022] [Indexed: 11/18/2022] Open
Abstract
To identify new antibodies for the treatment of plasma cell disorders including multiple myeloma (MM), a single-chain Fragment variable (scFv) antibody library was generated by immunizing mice with patient-derived malignant plasma cells. To enrich antibodies binding myeloma antigens, phage display with cellular panning was performed. After depleting the immune library with leukocytes of healthy donors, selection of antibodies was done with L-363 plasma cell line in two consecutive panning rounds. Monitoring the antibodies’ enrichment throughout the panning by next-generation sequencing (NGS) identified several promising candidates. Initially, 41 unique scFv antibodies evolving from different B cell clones were selected. Nine of these antibodies strongly binding to myeloma cells and weakly binding to peripheral blood mononuclear cells (PBMC) were characterized. Using stably transfected Chinese hamster ovary cells expressing individual myeloma-associated antigens revealed that two antibodies bind CD38 and intercellular adhesion molecule-1 (ICAM-1), respectively, and 7 antibodies target yet unknown antigens. To evaluate the therapeutic potential of our new antibodies, in a first proof-of-concept study the CD38 binding scFv phage antibody was converted into a chimeric IgG1. Further analyses revealed that #5-CD38-IgG1 shared an overlapping epitope with daratumumab and isatuximab and had potent anti-myeloma activity comparable to the two clinically approved CD38 antibodies. These results indicate that by phage display and deep sequencing, new antibodies with therapeutic potential for MM immunotherapy can be identified.
Collapse
Affiliation(s)
- Steffen Krohn
- Division of Antibody-Based Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Ammelie Svea Boje
- Division of Antibody-Based Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Carina Lynn Gehlert
- Division of Antibody-Based Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Sebastian Lutz
- Division of Antibody-Based Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Nikos Darzentas
- Unit for Hematological Diagnostics, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Henrik Knecht
- Unit for Hematological Diagnostics, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dietrich Herrmann
- Unit for Hematological Diagnostics, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Monika Brüggemann
- Unit for Hematological Diagnostics, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Axel J. Scheidig
- Zoological Institute, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Katja Weisel
- Department of Oncology, Hematology, Bone Marrow Transplant (BMT) with Section of Pneumology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Martin Gramatzki
- Division of Antibody-Based Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Matthias Peipp
- Division of Antibody-Based Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Katja Klausz
- Division of Antibody-Based Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
- *Correspondence: Katja Klausz,
| |
Collapse
|
5
|
Klausz K, Kellner C, Gehlert CL, Krohn S, Wilcken H, Floerkemeier I, Günther A, Bauerschlag DO, Clement B, Gramatzki M, Peipp M. The Novel Dual Topoisomerase Inhibitor P8-D6 Shows Anti-myeloma Activity In Vitro and In Vivo. Mol Cancer Ther 2021; 21:70-78. [PMID: 34725192 DOI: 10.1158/1535-7163.mct-21-0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 10/04/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022]
Abstract
P8-D6 is a novel dual inhibitor of human topoisomerase I (TOP1) and II (TOP2) with broad pro-apoptotic antitumor activity. NCI-60 screening revealed markedly improved cytotoxicity of P8-D6 against solid and leukemia cell lines compared with other single and dual topoisomerase inhibitors, for example, irinotecan, doxorubicin, or pyrazoloacridine. In this study, we investigated the capacity of P8-D6 to inhibit myeloma cell growth in vitro and in vivo Growth inhibition assays demonstrated significant anti-myeloma effects against different myeloma cell lines with IC50 values in the low nanomolar range. Freshly isolated plasma cells of patients with multiple myeloma were killed by P8-D6 with similar doses. P8-D6 activated caspase 3/7 and induced significant apoptosis of myeloma cells. Supportive effects of bone marrow stromal cells on IL6-dependent INA-6 myeloma cells were abrogated by P8-D6 and apoptosis occurred in a time- and dose-dependent manner. Of note, healthy donor peripheral blood mononuclear cells and human umbilical vein endothelial cells were not affected at concentrations toxic for malignant plasma cells. Treatment of myeloma xenografts in immunodeficient SCID/beige mice by intravenous and, notably, also oral application of P8-D6 markedly inhibited tumor growths, and significantly prolonged survival of tumor-bearing mice.
Collapse
Affiliation(s)
- Katja Klausz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Kiel, and Christian-Albrechts-University, Kiel, Germany.
| | - Christian Kellner
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, Munich, Germany
| | - Carina Lynn Gehlert
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Kiel, and Christian-Albrechts-University, Kiel, Germany
| | - Steffen Krohn
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Kiel, and Christian-Albrechts-University, Kiel, Germany
| | - Hauke Wilcken
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Kiel, and Christian-Albrechts-University, Kiel, Germany
| | - Inken Floerkemeier
- Department of Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Andreas Günther
- Helios Clinics Schwerin, Hematology/Oncology/Stem Cell Transplantation, Schwerin, Germany
| | - Dirk O Bauerschlag
- Department of Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Bernd Clement
- Department of Pharmaceutical and Medicinal Chemistry, Pharmaceutical Institute, Christian-Albrechts-University, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Kiel, and Christian-Albrechts-University, Kiel, Germany
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Kiel, and Christian-Albrechts-University, Kiel, Germany
| |
Collapse
|
6
|
Kellner C, Lutz S, Oberg HH, Wesch D, Otte A, Diemer KJ, Wilcken H, Bauerschlag D, Glüer CC, Wichmann C, Kabelitz D, Leusen JHW, Klausz K, Humpe A, Gramatzki M, Peipp M. Tumor cell lysis and synergistically enhanced antibody-dependent cell-mediated cytotoxicity by NKG2D engagement with a bispecific immunoligand targeting the HER2 antigen. Biol Chem 2021; 403:545-556. [PMID: 34717050 DOI: 10.1515/hsz-2021-0229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 10/13/2021] [Indexed: 11/15/2022]
Abstract
Natural killer group 2 member D (NKG2D) plays an important role in the regulation of natural killer (NK) cell cytotoxicity in cancer immune surveillance. With the aim of redirecting NK cell cytotoxicity against tumors, the NKG2D ligand UL-16 binding protein 2 (ULBP2) was fused to a single-chain fragment variable (scFv) targeting the human epidermal growth factor receptor 2 (HER2). The resulting bispecific immunoligand ULBP2:HER2-scFv triggered NK cell-mediated killing of HER2-positive breast cancer cells in an antigen-dependent manner and required concomitant interaction with NKG2D and HER2 as revealed in antigen blocking experiments. The immunoligand induced tumor cell lysis dose-dependently and was effective at nanomolar concentrations. Of note, ULBP2:HER2-scFv sensitized tumor cells for antibody-dependent cell-mediated cytotoxicity (ADCC). In particular, the immunoligand enhanced ADCC by cetuximab, a therapeutic antibody targeting the epidermal growth factor receptor (EGFR) synergistically. No significant improvements were obtained by combining cetuximab and anti-HER2 antibody trastuzumab. In conclusion, dual-dual targeting by combining IgG1 antibodies with antibody constructs targeting another tumor associated antigen and engaging NKG2D as a second NK cell trigger molecule may be promising. Thus, the immunoligand ULBP2:HER2-scFv may represent an attractive biological molecule to promote NK cell cytotoxicity against tumors and to boost ADCC.
Collapse
Affiliation(s)
- Christian Kellner
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, Max-Lebsche-Platz 32, D-81377Munich, Germany
| | - Sebastian Lutz
- Department of Medicine II, Division of Stem Cell Transplantation and Immunotherapy, Christian-Albrechts-University of Kiel, D-24105Kiel, Germany
| | - Hans-Heinrich Oberg
- Institute of Immunology, Christian-Albrechts-University of Kiel and University Hospital Schleswig-Holstein, D-24105Kiel, Germany
| | - Daniela Wesch
- Institute of Immunology, Christian-Albrechts-University of Kiel and University Hospital Schleswig-Holstein, D-24105Kiel, Germany
| | - Anna Otte
- Department of Medicine II, Division of Stem Cell Transplantation and Immunotherapy, Christian-Albrechts-University of Kiel, D-24105Kiel, Germany
| | - Katarina J Diemer
- Department of Medicine II, Division of Stem Cell Transplantation and Immunotherapy, Christian-Albrechts-University of Kiel, D-24105Kiel, Germany
| | - Hauke Wilcken
- Department of Medicine II, Division of Stem Cell Transplantation and Immunotherapy, Christian-Albrechts-University of Kiel, D-24105Kiel, Germany
| | - Dirk Bauerschlag
- Department of Gynecology and Obestrics, University Medical Centre Schleswig-Holstein, Campus Kiel, D-24105Kiel, Germany
| | - Claus-Christian Glüer
- Department of Radiology and Neurology, Section Biomedical Imaging, University Hospital Schleswig-Holstein, D-24118Kiel, Germany
| | - Christian Wichmann
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, Max-Lebsche-Platz 32, D-81377Munich, Germany
| | - Dieter Kabelitz
- Institute of Immunology, Christian-Albrechts-University of Kiel and University Hospital Schleswig-Holstein, D-24105Kiel, Germany
| | - Jeanette H W Leusen
- Laboratory of Translational Immunology, University Medical Center, NL-3584Utrecht, Netherlands
| | - Katja Klausz
- Department of Medicine II, Division of Stem Cell Transplantation and Immunotherapy, Christian-Albrechts-University of Kiel, D-24105Kiel, Germany
| | - Andreas Humpe
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, Max-Lebsche-Platz 32, D-81377Munich, Germany
| | - Martin Gramatzki
- Department of Medicine II, Division of Stem Cell Transplantation and Immunotherapy, Christian-Albrechts-University of Kiel, D-24105Kiel, Germany
| | - Matthias Peipp
- Department of Medicine II, Division of Stem Cell Transplantation and Immunotherapy, Christian-Albrechts-University of Kiel, D-24105Kiel, Germany
| |
Collapse
|
7
|
Burger R, Otte A, Brdon J, Peipp M, Gramatzki M. Dual intracellular targeting by ruxolitinib and the Mcl-1 inhibitor S63845 in interleukin-6-dependent myeloma cells blocks. Haematologica 2021; 106:2507-2510. [PMID: 33882638 PMCID: PMC8409037 DOI: 10.3324/haematol.2020.276865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Renate Burger
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Medical Center Schleswig-Holstein and University of Kiel, Kiel.
| | - Anna Otte
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Medical Center Schleswig-Holstein and University of Kiel, Kiel
| | - Jan Brdon
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Medical Center Schleswig-Holstein and University of Kiel, Kiel
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Medical Center Schleswig-Holstein and University of Kiel, Kiel
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Medical Center Schleswig-Holstein and University of Kiel, Kiel
| |
Collapse
|
8
|
Straka C, Salwender H, Knop S, Vogel M, Müller J, Metzner B, Langer C, Sayer H, Jung W, Dürk HA, Bassermann F, Gramatzki M, Rösler W, Wolf HH, Brugger W, Engelhardt M, Fischer T, Liebisch P, Einsele H. Full or intensity-reduced high-dose melphalan and single or double autologous stem cell transplant with or without bortezomib consolidation in patients with newly diagnosed multiple myeloma. Eur J Haematol 2021; 107:529-542. [PMID: 34270825 DOI: 10.1111/ejh.13690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE A post hoc subgroup analysis of two phase III trials (NCT00416273, NCT00416208) was carried out to investigate the influence of 100/140 and 200 mg/m² melphalan as well as single/double autologous stem cell transplantation (ASCT) on progression-free survival (PFS). Additionally, the effect of bortezomib consolidation on PFS was analyzed. METHODS Following induction therapy and high-dose melphalan with subsequent ASCT, patients with newly diagnosed multiple myeloma (NDMM) were randomized 1:1 to either four 35-day cycles of bortezomib consolidation (1.6 mg/m² IV on days 1, 8, 15, 22) or observation. RESULTS Of the 340 patients included in this analysis, 13.5% received 1 × MEL100/140, 22.9% 2 × MEL100/140, 31.2% 1 × MEL200, and 32.4% 2 × MEL200. With higher cumulative melphalan dose, PFS improved (P = .0085). PFS curves of patients treated with 2 × MEL100/140 and 1 × MEL200 were very similar. The superior dose effect of MEL200 over MEL100/140 was non-existent in the bortezomib consolidation arm but pronounced in the observation arm (P = .0015). Similarly, double ASCT was only beneficial in patients without bortezomib consolidation (P = .0569). CONCLUSIONS Full dose melphalan and double transplantation seem advantageous only as long as patients are not receiving bortezomib consolidation afterwards.
Collapse
Affiliation(s)
| | - Hans Salwender
- Asklepios Tumorzentrum, AK Altona und AK St. Georg, Hamburg, Germany
| | - Stefan Knop
- Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany
| | | | | | - Bernd Metzner
- Universitätsklinik für Innere Medizin II, Oldenburg, Germany
| | - Christian Langer
- Universitätsklinikum Ulm, Klinik für Innere Medizin II, Ulm, Germany
| | - Herbert Sayer
- Universitätsklinikum Jena, Klinik für Innere Medizin II, Jena, Germany
| | - Wolfram Jung
- Universitätsmedizin Göttingen, Göttingen, Germany
| | | | - Florian Bassermann
- Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | | | - Wolf Rösler
- Universitätsklinikum Erlangen, Erlangen, Germany
| | | | | | | | | | - Peter Liebisch
- Universitätsklinikum Ulm, Klinik für Innere Medizin II, Ulm, Germany
| | - Hermann Einsele
- Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany
| |
Collapse
|
9
|
Gay F, Günther A, Offidani M, Engelhardt M, Salvini M, Montefusco V, Patriarca F, Aquino S, Pönisch W, Spada S, Schub N, Gentili S, Wäsch R, Corradini P, Straka C, Palumbo A, Einsele H, Boccadoro M, Sonneveld P, Gramatzki M. Carfilzomib, bendamustine, and dexamethasone in patients with advanced multiple myeloma: The EMN09 phase 1/2 study of the European Myeloma Network. Cancer 2021; 127:3413-3421. [PMID: 34181755 DOI: 10.1002/cncr.33647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/22/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Combined therapy with carfilzomib, bendamustine, and dexamethasone was evaluated in this multicenter phase 1/2 trial conducted within the European Myeloma Network (EMN09 trial). METHODS Sixty-three patients with relapsed/refractory multiple myeloma who had received ≥2 lines of prior therapy were included. The phase 1 portion of the study determined the maximum tolerated dose of carfilzomib with bendamustine set at 70 mg/m2 on days 1 and 8. After 8 cycles, responding patients received maintenance therapy with carfilzomib and dexamethasone until progression. RESULTS On the basis of the phase 1 results, the recommended phase 2 dose for carfilzomib was 27 mg/m2 twice weekly in weeks 1, 2, and 3. Fifty-two percent of patients achieved a partial response or better, and 32% reached a very good partial response or better. The clinical benefit rate was 93%. After a median follow-up of 21.9 months, the median progression-free survival was 11.6 months, and the median overall survival was 30.4 months. The reported grade ≥3 hematologic adverse events (AEs) were lymphopenia (29%), neutropenia (25%), and thrombocytopenia (22%). The main nonhematologic grade ≥3 AEs were pneumonia, thromboembolic events (10%), cardiac AEs (8%), and hypertension (2%). CONCLUSIONS In heavily pretreated patients who have relapsed/refractory multiple myeloma, combined carfilzomib, bendamustine, and dexamethasone is an effective treatment option administered in the outpatient setting. Infection prophylaxis and attention to patients with cardiovascular predisposition are required.
Collapse
Affiliation(s)
- Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Andreas Günther
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - Massimo Offidani
- Hematology Clinic, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Monika Engelhardt
- Department for Hematology and Oncology, University of Freiburg, Faculty of Freiburg, Freiburg, Germany
| | - Marco Salvini
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Vittorio Montefusco
- Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Sara Aquino
- Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Wolfram Pönisch
- Department of Hematology, University of Leipzig, Leipzig, Germany
| | - Stefano Spada
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Natalie Schub
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | | | - Ralph Wäsch
- Department for Hematology and Oncology, University of Freiburg, Faculty of Freiburg, Freiburg, Germany
| | - Paolo Corradini
- Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Christian Straka
- Department of Hematology and Oncology, Munich Clinic Schwabing, Munich, Germany
| | - Antonio Palumbo
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Hermann Einsele
- Department of Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Pieter Sonneveld
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| |
Collapse
|
10
|
Kharfan-Dabaja MA, Labopin M, Brissot E, Kroger N, Finke J, Ciceri F, Deconinck E, Blaise D, Chevallier P, Gramatzki M, Ganser A, Stelljes M, Edinger M, Savani B, Ruggeri A, Sanz J, Nagler A, Mohty M. Second allogeneic haematopoietic cell transplantation using HLA-matched unrelated versus T-cell replete haploidentical donor and survival in relapsed acute myeloid leukaemia. Br J Haematol 2021; 193:592-601. [PMID: 33838047 DOI: 10.1111/bjh.17426] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/01/2021] [Indexed: 12/17/2022]
Abstract
Optimal donor choice for a second allogeneic haematopoietic cell transplant (allo-HCT) in relapsed acute myeloid leukaemia (AML) remains unknown. We compared overall survival (OS) using registry data from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) involving 455 adults who received a second allo-HCT from a human leucocyte antigen (HLA)-matched unrelated (MUD) (n = 320) or a haploidentical (n = 135) donor. Eligibility criteria required adults aged ≥18 years who received a second allo-HCT for treating AML relapse between 2005 and 2019. The primary end-point was OS. There was no statistically significant difference in the median (interquartile range) age between the groups, MUD 46 (35-58) versus haploidentical 44 (33-53) years (P = 0·07). The median OS was not different between the MUD and the haploidentical groups (10 vs. 11 months, P = 0·57). Similarly, the 2-year OS was 31% for the MUD and 29% for the haploidentical donor groups. The OS was worse if the procedure was performed with active AML [hazard ratio (HR) 1·42, 95% confidence interval (CI) 1·07-1·89; P = 0·02]. Conversely, a longer time from first allo-HCT to relapse (>13·2 months) was associated with better OS (HR 0·50, 95% CI 0·37-0·69; P < 0·0001). The results of the present analysis limit the ability to recommend one donor type over another when considering a second allo-HCT for relapsed AML. Our findings highlight that best OS is achieved when receiving the second allo-HCT in complete remission.
Collapse
Affiliation(s)
- Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Myriam Labopin
- Department of Hematology, Hôpital Saint Antoine, Sorbonne University and INSERM UMRs 938, Paris, France
| | - Eolia Brissot
- Department of Hematology, Hôpital Saint Antoine, Sorbonne University and INSERM UMRs 938, Paris, France
| | - Nicolaus Kroger
- Bone Marrow Transplantation Centre, University Hospital Eppendorf, Hamburg, Germany
| | - Jürgen Finke
- Department of Medicine I, Hematology, Oncology, Stem Cell Transplantation, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabio Ciceri
- Ospedale San Raffaele s.r.l., Haematology and BMT, Milan, Italy
| | - Eric Deconinck
- Service d'Hématologie, Centre hopitalier universitaire Besancon, Besancon, France
| | - Didier Blaise
- Institut Paoli Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France
| | - Patrice Chevallier
- Department of D'Hematologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Martin Gramatzki
- División of Stem Cell Transplantation and Immunotherapy, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Arnold Ganser
- Department of Haematology, Hemostasis, Oncology, Hannover Medical School, Hannover, Germany
| | - Matthias Stelljes
- Department of Hematology/Oncology, University of Muenster, Muenster, Germany
| | - Matthias Edinger
- Department of Hematology and Oncology and RCI, University Regensburg, Regensburg, Germany
| | - Bipin Savani
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Annalisa Ruggeri
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jaime Sanz
- Hematology Department, Hospital Universitari i Politècnic La Fe, Avinguda Fernando Abril Martorell, Valencia, Spain
| | - Arnon Nagler
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) Office, Saint Antoine Hospital, Paris, France
| | - Mohamad Mohty
- Department of Hematology, Hôpital Saint Antoine, Sorbonne University and INSERM UMRs 938, Paris, France.,Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) Office, Saint Antoine Hospital, Paris, France
| |
Collapse
|
11
|
Roßkopf S, Eichholz KM, Winterberg D, Diemer KJ, Lutz S, Münnich IA, Klausz K, Rösner T, Valerius T, Schewe DM, Humpe A, Gramatzki M, Peipp M, Kellner C. Enhancing CDC and ADCC of CD19 Antibodies by Combining Fc Protein-Engineering with Fc Glyco-Engineering. Antibodies (Basel) 2020; 9:antib9040063. [PMID: 33212776 PMCID: PMC7709100 DOI: 10.3390/antib9040063] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Native cluster of differentiation (CD) 19 targeting antibodies are poorly effective in triggering antibody-dependent cell-mediated cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC), which are crucial effector functions of therapeutic antibodies in cancer immunotherapy. Both functions can be enhanced by engineering the antibody’s Fc region by altering the amino acid sequence (Fc protein-engineering) or the Fc-linked glycan (Fc glyco-engineering). We hypothesized that combining Fc glyco-engineering with Fc protein-engineering will rescue ADCC and CDC in CD19 antibodies. Results: Four versions of a CD19 antibody based on tafasitamab’s V-regions were generated: a native IgG1, an Fc protein-engineered version with amino acid exchanges S267E/H268F/S324T/G236A/I332E (EFTAE modification) to enhance CDC, and afucosylated, Fc glyco-engineered versions of both to promote ADCC. Irrespective of fucosylation, antibodies carrying the EFTAE modification had enhanced C1q binding and were superior in inducing CDC. In contrast, afucosylated versions exerted an enhanced affinity to Fcγ receptor IIIA and had increased ADCC activity. Of note, the double-engineered antibody harboring the EFTAE modification and lacking fucose triggered both CDC and ADCC more efficiently. Conclusions: Fc glyco-engineering and protein-engineering could be combined to enhance ADCC and CDC in CD19 antibodies and may allow the generation of antibodies with higher therapeutic efficacy by promoting two key functions simultaneously.
Collapse
Affiliation(s)
- Sophia Roßkopf
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
| | - Klara Marie Eichholz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
| | - Dorothee Winterberg
- Pediatric Hematology/Oncology, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (D.W.); (D.M.S.)
| | - Katarina Julia Diemer
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
| | - Sebastian Lutz
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, 81377 Munich, Germany; (S.L.); (I.A.M.); (A.H.); (C.K.)
| | - Ira Alexandra Münnich
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, 81377 Munich, Germany; (S.L.); (I.A.M.); (A.H.); (C.K.)
| | - Katja Klausz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
| | - Thies Rösner
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
| | - Thomas Valerius
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
| | - Denis Martin Schewe
- Pediatric Hematology/Oncology, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (D.W.); (D.M.S.)
| | - Andreas Humpe
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, 81377 Munich, Germany; (S.L.); (I.A.M.); (A.H.); (C.K.)
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (S.R.); (K.M.E.); (K.J.D.); (K.K.); (T.R.); (T.V.); (M.G.)
- Correspondence: ; Tel.: +49-431-500-22701
| | - Christian Kellner
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, 81377 Munich, Germany; (S.L.); (I.A.M.); (A.H.); (C.K.)
| |
Collapse
|
12
|
Bento L, Boumendil A, Finel H, Khvedelidze I, Blaise D, Fegueux N, Castagna L, Forcade E, Chevallier P, Mordini N, Brice P, Deconinck E, Gramatzki M, Corradini P, Hunault M, Musso M, Tsoulkani A, Caballero D, Nati S, Montoto S, Sureda A. Tandem autologous-reduced intensity allogeneic stem cell transplantation in high-risk relapsed Hodgkin lymphoma: a retrospective study of the Lymphoma Working Party-EBMT. Bone Marrow Transplant 2020; 56:655-663. [PMID: 33046830 DOI: 10.1038/s41409-020-01075-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 11/09/2022]
Abstract
Autologous hematopoietic stem cell transplantation (ASCT) is curative for a proportion of patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL). However, there is a small group of patients with high-risk of relapse after ASCT that might benefit from other approaches. We conducted a retrospective analysis on 126 patients treated with tandem ASCT-reduced intensity conditioning (RIC)-allogeneic-SCT and reported to the EBMT registry to analyze the efficacy and safety of this approach. Patients were included if they had received an ASCT followed by a planned RIC-SCT in <6 months without relapse between the procedures. The median time between diagnosis and ASCT was 16 months (2-174). The median number of lines prior to ASCT was two (33% of the patients received >3 lines). Forty-one percent were transplanted with active disease. The median follow-up was 44 months (6-130). Three-year-progression-free survival (PFS), overall survival (OS), incidence of relapse (IR), and non-relapse mortality (NRM) after the tandem were 53% (45-64), 73% (65-81), 34% (24-42), and 13% (8-21), respectively. This is the largest series analyzing the efficacy and safety of a tandem approach in R/R HL. The low NRM and IR with promising PFS and OS suggest that this might be an effective procedure for a high-risk population.
Collapse
Affiliation(s)
- Leyre Bento
- Hematology Department, Son Espases University Hospital, IdISBa, Palma de Mallorca, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sandro Nati
- Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Silvia Montoto
- St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Anna Sureda
- Institut Català d'Oncologia (ICO)-Hospitalet, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | | |
Collapse
|
13
|
Loke J, Labopin M, Craddock C, Niederwieser D, Cornelissen J, Afansayev B, Jindra P, Maertens J, Blaise D, Boriskina K, Gramatzki M, Ganser A, Savani B, Mohty M, Nagler A. Impact of patient: donor HLA disparity on reduced-intensity-conditioned allogeneic stem cell transplants from HLA mismatched unrelated donors for AML: from the ALWP of the EBMT. Bone Marrow Transplant 2020; 56:614-621. [PMID: 33009514 DOI: 10.1038/s41409-020-01072-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/06/2020] [Accepted: 09/21/2020] [Indexed: 11/09/2022]
Abstract
Patients with acute myeloid leukaemia (AML) who lack a matched sibling or unrelated donor commonly undergo transplantation from a donor matched at 9/10 HLA-A, -B, -C, -DRB1, -DQB1 alleles, and it is unclear if a specific locus mismatch is preferable to any other. We therefore studied 937 patients with AML in complete remission transplanted using a reduced intensity conditioning regimen from an unrelated donor mismatched at a single allele. In a multivariate analysis, patient age, adverse karyotype and patient cytomegalovirus (CMV) seropositivity were correlated with decreased leukaemia free survival (LFS) and overall survival (OS). There was no significant difference in LFS or OS between patients transplanted from donors mismatched at HLA-A, -B, -C or -DRB1 in comparison to a HLA-DQB1 mismatched transplant. In a multivariate analysis, patients transplanted with a HLA-A mismatched donor had higher rates of acute graft-versus-host disease (GVHD) and non-relapse mortality (NRM) than patients transplanted with a HLA-DQB1 mismatched donor. Patient CMV seropositivity was associated with an increase in NRM and acute GVHD and reduced LFS and OS, regardless of donor CMV status. For CMV seropositive patients lacking a fully matched donor, alternative GVHD and CMV prophylaxis strategies should be considered.
Collapse
Affiliation(s)
- J Loke
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - M Labopin
- Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France.,Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France
| | - C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK.
| | | | - J Cornelissen
- Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | - B Afansayev
- State Medical Pavlov University, St. Petersburg, Russia
| | - P Jindra
- Department of Haematology/Oncology, Charles University Hospital, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - J Maertens
- Department of Hematology, Acute Leukemia and Transplantation Unit, UZ Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - D Blaise
- Transplant and Cellular Therapy Unit, Institut Paoli Calmettes, Marseille, France
| | - K Boriskina
- Department of Hematology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - A Ganser
- Department of Haematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, Germany
| | - B Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - M Mohty
- Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France.,Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| |
Collapse
|
14
|
Klausz K, Cieker M, Kellner C, Rösner T, Otte A, Krohn S, Lux A, Nimmerjahn F, Valerius T, Gramatzki M, Peipp M. Fc-engineering significantly improves the recruitment of immune effector cells by anti-ICAM-1 antibody MSH-TP15 for myeloma therapy. Haematologica 2020; 106:1857-1866. [PMID: 32499243 PMCID: PMC8252953 DOI: 10.3324/haematol.2020.251371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Indexed: 12/30/2022] Open
Abstract
Despite several therapeutic advances, patients with multiple myeloma (MM) require additional treatment options since no curative therapy exists yet. In search of a novel therapeutic antibody, we previously applied phage display with myeloma cell screening and developed TP15, a scFv targeting intercellular adhesion molecule 1 (ICAM-1/CD54). To more precisely evaluate the antibody's modes of action, fully human IgG1 antibody variants were generated bearing wild-type (MSH-TP15) or mutated Fc to either enhance (MSH-TP15 Fc-eng.) or prevent (MSH-TP15 Fc k.o.) Fc gamma receptor binding. Especially MSH-TP15 Fc-eng. induced potent antibody-dependent cell-mediated cytotoxicity (ADCC) against malignant plasma cells by efficiently recruiting NK cells and engaged macrophages for antibody-dependent cellular phagocytosis (ADCP) of tumor cells. Binding studies with truncated ICAM-1 demonstrated MSH-TP15 binding to ICAM-1 domain 1-2. Importantly, MSH-TP15 and MSH-TP15 Fc-eng. both prevented myeloma cell engraftment and significantly prolonged survival of mice in an intraperitoneal xenograft model. In the subcutaneous model MSH-TP15 Fc-eng. was superior to MSH-TP15, whereas MSH-TP15 Fc k.o. was not effective in both models - reflecting the importance of Fc-dependent mechanisms of action also in vivo. The efficient recruitment of immune cells and the potent anti-tumor activity of the Fc-engineered MSH-TP15 antibody hold significant potential for myeloma immunotherapy.
Collapse
Affiliation(s)
- Katja Klausz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel
| | - Michael Cieker
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel
| | - Christian Kellner
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital, LMU Munich, Munich
| | - Thies Rösner
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel
| | - Anna Otte
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel
| | - Steffen Krohn
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel
| | - Anja Lux
- Institute of Genetics, Department of Biology, University of Erlangen-Nurnberg, Erlangen, Germany
| | - Falk Nimmerjahn
- Institute of Genetics, Department of Biology, University of Erlangen-Nurnberg, Erlangen, Germany
| | - Thomas Valerius
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University, Kiel,MATTHIAS PEIPP
| |
Collapse
|
15
|
Shimoni A, Labopin M, Finke J, Ciceri F, Deconinck E, Kröger N, Gramatzki M, Stelljes M, Blaise D, Stoelzel F, Chevallier P, Holler E, Fegueux N, Mohty M, Nagler A. Donor selection for a second allogeneic stem cell transplantation in AML patients relapsing after a first transplant: a study of the Acute Leukemia Working Party of EBMT. Blood Cancer J 2019; 9:88. [PMID: 31740656 PMCID: PMC6861251 DOI: 10.1038/s41408-019-0251-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 01/17/2023] Open
Abstract
Second allogeneic stem-cell transplantation (SCT2) is a therapeutic option for patients with AML relapsing after a first transplant. Prior studies have shown similar results after SCT2 from the same or different donor; however, there are limited data on second non-T-depleted haplo-identical transplant in this setting. We retrospectively analyzed SCT2 outcomes in 556 patients, median age 46 years, relapsing after first transplant given in CR1. Patients were divided into three groups based on SCT2 donor (donor2): same donor (n = 163, sib/sib-112, UD/UD-51), different matched donor (n = 305, sib/different sib-44, sib/UD-93, UD/different UD-168), or haplo-donor (n = 88, sib/haplo-45, UD/haplo-43). Two-year leukemia-free survival (LFS) rate after SCT2 was 23.5%, 23.7%, and 21.8%, respectively (P = 0.30). Multivariate analysis showed no effect of donor2 type on relapse: hazard ratio (HR) 0.89 (P = 0.57) and 1.11 (P = 0.68) for different donor and haplo-donor compared to same donor, respectively. However, donor2 did predict for non-relapse mortality (NRM) after SCT2: HR 1.21 (P = 0.50) and 2.08 (P = 0.03), respectively, and for LFS: HR 1.00 (P = 0.97) and 1.43 (P = 0.07), respectively. In conclusion, SCT2 with the same or different matched donor is associated with similar outcomes in patients with relapsed AML. Non-T-depleted haplo-identical transplant may be associated with higher NRM, similar relapse rate and with no better results in this setting.
Collapse
Affiliation(s)
- Avichai Shimoni
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel.
| | | | - Jürgen Finke
- Department of Medicine, Hematology-Oncology, University of Freiburg, Freiburg, Germany
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eric Deconinck
- Service d'Hématologie, Hopital Jean Minjoz, Besancon, France
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation & Immunotherapy, 2nd Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Matthias Stelljes
- Department of Internal Medicine A, University of Muenster, Muenster, Germany
| | - Didier Blaise
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - Friedrich Stoelzel
- Department of Hematology/Oncology, Medical Clinic and Policlinic, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany
| | | | - Ernst Holler
- Department of Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | | | - Mohamad Mohty
- Acute Leukemia Working Party of EBMT, Paris, France.,Department of Haematology, Saint Antoine Hospital, Paris, France
| | - Arnon Nagler
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel.,Acute Leukemia Working Party of EBMT, Paris, France
| |
Collapse
|
16
|
Andersen NS, Bornhäuser M, Gramatzki M, Dreger P, Vitek A, Karas M, Michallet M, Moreno C, van Gelder M, Henseler A, de Wreede LC, Schönland S, Kröger N, Schetelig J. Reduced intensity conditioning regimens including alkylating chemotherapy do not alter survival outcomes after allogeneic hematopoietic cell transplantation in chronic lymphocytic leukemia compared to low-intensity non-myeloablative conditioning. J Cancer Res Clin Oncol 2019; 145:2823-2834. [DOI: 10.1007/s00432-019-03014-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 08/22/2019] [Indexed: 12/16/2022]
|
17
|
Straka C, Knop S, Vogel M, Müller J, Kropff M, Metzner B, Langer C, Sayer H, Jung W, Dürk HA, Salwender H, Wandt H, Bassermann F, Gramatzki M, Rösler W, Wolf H, Brugger W, Fischer T, Liebisch P, Engelhardt M, Einsele H. Bortezomib consolidation following autologous transplant in younger and older patients with newly diagnosed multiple myeloma in two phase III trials. Eur J Haematol 2019; 103:255-267. [DOI: 10.1111/ejh.13281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 01/10/2023]
Affiliation(s)
| | - Stefan Knop
- Medizinische Klinik und Poliklinik II Julius Maximilians Universität Würzburg Würzburg Germany
| | | | | | | | - Bernd Metzner
- Universitätsklinik für Innere Medizin – Onkologie und Hämatologie Klinikum Oldenburg Oldenburg Germany
| | | | - Herbert Sayer
- Klinik für Innere Medizin II [Hämatologie/Onkologie] Universitätsklinikum Jena Jena Germany
| | - Wolfram Jung
- Onkologie Universitätsmedizin Göttingen Göttingen Germany
| | | | | | - Hannes Wandt
- Medizinische Klinik 5 Paracelsus Medizinische Privatuniversität Nürnberg Nürnberg Germany
| | - Florian Bassermann
- Klinikum rechts der Isar, III. Medizinische Klinik Technische Universität München München Germany
| | | | - Wolf Rösler
- Universitätsklinkum Erlangen Erlangen Germany
| | | | | | | | - Peter Liebisch
- Zentrum für Innere Medizin Universitätsklinikum Ulm Ulm Germany
| | | | - Hermann Einsele
- Medizinische Klinik und Poliklinik II Julius Maximilians Universität Würzburg Würzburg Germany
| |
Collapse
|
18
|
Bringhen S, Milan A, D'Agostino M, Ferri C, Wäsch R, Gay F, Larocca A, Offidani M, Zweegman S, Terpos E, Goldschmidt H, Cavo M, Ludwig H, Driessen C, Auner HW, Caers J, Gramatzki M, Dimopoulos MA, Boccadoro M, Einsele H, Sonneveld P, Engelhardt M. Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension. J Intern Med 2019; 286:63-74. [PMID: 30725503 DOI: 10.1111/joim.12882] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The novel proteasome inhibitor carfilzomib alone or in combination with other agents is already one of the standard therapies for relapsed and/or refractory multiple myeloma (MM) patients and produces impressive response rates in newly diagnosed MM as well. However, carfilzomib-related cardiovascular adverse events (CVAEs) - including hypertension (all grades: 12.2%; grade ≥3: 4.3%), heart failure (all grades: 4.1%; grade ≥3: 2.5%) and ischemic heart disease (all grades: 1.8%; grade ≥3: 0.8%) - may lead to treatment suspensions. At present, there are neither prospective studies nor expert consensus on the prevention, monitoring and treatment of CVAEs in myeloma patients treated with carfilzomib. METHODS An expert panel of the European Myeloma Network in collaboration with the Italian Society of Arterial Hypertension and with the endorsement of the European Hematology Association aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk-benefit ratio of diagnostic and therapeutic tools, thereby achieving myeloma response with novel combination approaches whilst preventing CVAEs. RESULTS Patients scheduled to receive carfilzomib need a careful cardiovascular evaluation before treatment and an accurate follow-up during treatment. CONCLUSIONS A detailed clinical assessment before starting carfilzomib treatment is essential to identify patients at risk for CVAEs, and accurate monitoring of blood pressure and of early signs and symptoms suggestive of cardiac dysfunction remains pivotal to safely administer carfilzomib without treatment interruptions or dose reductions.
Collapse
Affiliation(s)
- S Bringhen
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - A Milan
- Department of Medical Sciences, Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza di Torino, Rete Oncologica Piemontese, University of Torino, Torino, Italy
| | - M D'Agostino
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - C Ferri
- University of L'Aquila, MeSVA Department - San Salvatore Hospital, Division of Internal Medicine & Nephrology, Coppito, Italy
| | - R Wäsch
- Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - F Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - A Larocca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - M Offidani
- Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - S Zweegman
- Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Department of Hematology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - E Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - H Goldschmidt
- University Clinic Heidelberg, Internal Medicine V and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - M Cavo
- 'Seràgnoli' Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy
| | - H Ludwig
- 1. Medical Department and Oncology, Wilhelminenspital Wien, Vienna, Austria
| | - C Driessen
- Department of Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - H W Auner
- Faculty of Medicine, Department of Medicine, Imperial College London, London, UK
| | - J Caers
- Department of Hematology, Domaine University Liege, Liege, Belgium
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - M A Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - M Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - H Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - P Sonneveld
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - M Engelhardt
- Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
19
|
Klausz K, Karimzadeh-Tabrizi A, Buck M, Otte A, Krohn S, Kellner C, Klapper W, Peipp M, Gramatzki M. Potent targeting of B cell lymphoma and plasma cell tumors by a tetravalent, Fc-engineered antibody directed against the glycoantigen CD75s. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14004 Background: Monoclonal antibodies are established treatment options for B cell-derived malignancies, but relapse is still the major challenge. Novel target structures may open alternative avenues to develop effective antibody therapies. Here, we characterized the novel tetravalent antibody ‘EBU-141 Tetra’ and identified the glycoantigen CD75s (α-2,6-sialylated lactosamines) as suitable target structure for antibody-based therapy. CD75s was detected on most B cell lymphomas, including Burkitt’s lymphoma, FL, DLBCL, MCL, CLL, and plasma cell tumors. Classical Hodgkin lymphomas were consistently negative while reactivity on individual cases of peripheral T cell lymphoma was seen. To evaluate CD75s as a target for antibody therapy, we generated a tetravalent, Fc-engineered chEBU-141 IgG1 antibody with enhanced avidity for CD75s and potent effector functions. Methods: ‘EBU-141 Tetra’ was produced by transient transfection and purified by affinity chromatography. Direct anti-tumor effects and Fc-mediated effector functions were investigated in cell proliferation assays, by fluorescence microscopy and in 51Cr release experiments using lymphoma and myeloma cell lines and patient-derived tumor cells. Peripheral blood mononuclear cells and monocyte-derived macrophages of healthy donors were used as human effector cells in the experiments. Results: ‘EBU-141 Tetra’ showed improved binding to CD75s on cell surface of mature B cell lymphoma as well as myeloma plasma cells compared to the conventional chimeric antibody chEBU-141 IgG1. The higher avidity for CD75s resulted in markedly improved ADCC activity of ‘EBU-141 Tetra’ against Daudi Burkitt’s lymphoma, U266 plasma cells and CLL patient-derived tumor cells with EC50 values in the low nanomolar range. In addition, ‘EBU-141 Tetra’ demonstrated efficient phagocytosis of Burkitt’s lymphoma and myeloma cell lines. Thus, the novel tetravalent, chimeric, Fc-engineered antibody ‘EBU-141 Tetra’ efficiently recruits immune effector cells for tumor cell lysis. Conclusions: Our findings further demonstrate that highly potent IgG-like antibodies against glycan-structures can be generated from mouse IgM antibodies and may open a new therapeutic window for therapy of patients with mature B cell lymphomas and multiple myeloma.
Collapse
Affiliation(s)
- Katja Klausz
- Div. of Stem Cell Transplantation & Immunotherapy, Dept. of Medicine II, Kiel, Germany
| | | | - Malena Buck
- Div. of Stem Cell Transplantation & Immunotherapy, Dept. of Medicine II, Kiel, Germany
| | - Anna Otte
- Div. of Stem Cell Transplantation & Immunotherapy, Dept. of Medicine II, Kiel, Germany
| | - Steffen Krohn
- Div. of Stem Cell Transplantation & Immunotherapy, Dept. of Medicine II, Kiel, Germany
| | - Christian Kellner
- Department of Transfusion Medicine, Cell Therapeutics and Haemostasis, Munich, Germany
| | | | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University Hospital Schleswig-Holstein and Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University Hospital Schleswig-Holstein and Christian-Albrechts-University of Kiel, Kiel, Germany
| |
Collapse
|
20
|
Heudobler D, Elger T, Mayer S, Hart C, Vogelhuber M, Grube M, Hahn J, Lüke F, Ditz D, Günther A, Gramatzki M, Schmidt B, Ferenczy P, Herr W, Rechenmacher M, Reichle A. Biomodulatory therapy approach with lenalidomide in combination with pioglitazone, dexamethasone, and metronomic low-dose chemotherapy with treosulfan in patients with relapsed/refractory multiple myeloma > second-line. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.8037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8037 Background: Nowadays, therapy for relapsed or refractory multiple myeloma (rrMM) usually consists of multi-targeted combination regimens for achieving complete remission. In this context, resistance resembles a therapeutic challenge that may be overcome by novel biomodulatory therapies communicatively reprogramming dysregulated cellular and intercellular homeostasis in neoplasia. Methods: The present, prospective phase II, one-arm, one-stage multi-center, open label trial, following phase I, focused on reprogramming myeloma and adjacent stroma cells in order to control rrMM beyond > 2nd-line treatment and following lenalidomide resistance in prior line. Adults with rrMM were eligible for receiving continuously, oral, daily dexamethasone 1mg, pioglitazone 45mg, low-dose treosulfan as metronomic chemotherapy ( 250mg bid) and lenalidomide 15mg, respectively, until disease progression. Results: Thirty-nine patients (mean time since diagnosis, 5.7 years; 66.7% with age > 60 years) had received a median of 5.5 (range 2 to 10) prior treatments. 89.5% of the patients were refractory to last therapy (all IMiD resistant), and 48.7% had received autologous stem-cell transplants. The overall response rate (CR, VGPR) was 17.9%. Eighteen patients (46.2%) had partial response or better; ten patients (25.6%) had stable disease. The disease control rate (DCR) was 71.8%. Time-to-progression was not significantly different between IMiD refractory patients and those relapsing following prior IMiD therapy or between high-risk versus non-high-risk cytogenetics. The median progression-free survival (PFS) and overall survival was 5.6 months (95% confidence interval [CI], 3.8 to 8.5) and 17.6 months (95% [CI], 14.9 to 39.2), respectively. The major AE (NCI-CTCAE grade) with grade ≥ 3 and relation to study drugs was hematologic toxicity (N = 31, 67.4%). Due to scheduled dose reductions, this was associated with only 7 (15.2%) grade ≥ 3 infections. Conclusions: The favorable safety profile, encouraging efficacy and equivalent median PFS between biomodulatory and modern targeted therapy in a historic comparison reveal a proof of concept of combined biomodulatory therapy in patients with heavily pretreated and IMiD-resistant rrMM, which should be further evaluated. Clinical trial information: NCT001010243.
Collapse
Affiliation(s)
| | - Tanja Elger
- University Hospital Regensburg, Regensburg, Germany
| | | | | | - Martin Vogelhuber
- Department of Internal Medicine III, University of Regensburg, Regensburg, Germany
| | | | - Joachim Hahn
- University Hospital Regensburg, Regensburg, Germany
| | - Florian Lüke
- University Hospital Regensburg, Regensburg, Germany
| | - Diana Ditz
- Luzerner Kantonsspital, Luzern, Switzerland
| | | | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University Hospital Schleswig-Holstein and Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | | | - Wolfgang Herr
- UNIVERSITAETSKLINIKUM REGENSBURG, Regensburg, Germany
| | | | | |
Collapse
|
21
|
Gramatzki D, Szabo E, Gramatzki M, Peipp M, Weller M. Targeting of CD317 by the immunotoxin HM1.24-ETA’ to allow immunotherapy in glioblastoma patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13560 Background: Glioblastoma is the most common primary malignant brain tumor with a poor prognosis. CD317 (HM1.24) is a transmembrane protein and may exist in differently spliced variants. It is highly expressed on plasma cells in multiple myeloma, as well as in certain solid tumor types. While several antibody drug conjugates are already in clinical practice, small immunotoxins with a different intracellular mode of action are only established in hairy cell leukemia. The immunotoxin HM1.24-ETA’ protein is a CD317 single chain Fv (scFv) antibody fused to a truncated version of Pseudomonas aeruginosa exotoxin A (ETA’). Methods: In vivo CD317 mRNA expression in human glioma of different grades and survival probabilities of glioblastoma patients based on CD317 mRNA expression were analyzed using the database of the Cancer Genome Atlas network (TCGA). CD317 protein expression was analyzed by immunohistochemistry in a human tissue microarray (TMA). In vitro CD317 mRNA expression was assessed by RT-PCR and CD317 protein levels by flow cytometry in several human glioblastoma cell lines. A cytotoxicity assay after treatment with HM1.24-ETA’ immunotoxin was performed in human glioblastoma cell lines. Results: Data on mRNA expression from the TCGA database demonstrated, that CD317 was upregulated in human glioblastomas compared to lower grade gliomas. In the group of glioblastoma patients increased CD317 mRNA expression was associated with decreased probability of survival ( p< 0.001). CD317 protein levels correlated directly with the tumor grade of astrocytic gliomas in the TMA. CD317 was expressed heterogeneously on mRNA and protein levels in the tested cell-lines in vitro. HM1.24-ETA’ induced cytotoxicity in CD317-positive glioblastoma cells in a concentration-dependent manner. Animal experiments currently performed suggest activity in glioblastoma xenografted mice. Conclusions: These data highlight CD317 as an interesting target antigen and HM1.24-ETA’ immunotoxin as a strategy for immunotherapy of glioblastoma patients.
Collapse
Affiliation(s)
- Dorothee Gramatzki
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, and Neuroscience Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland
| | - Emese Szabo
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, and Neuroscience Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University Hospital Schleswig-Holstein and Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University Hospital Schleswig-Holstein and Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Michael Weller
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, and Neuroscience Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland
| |
Collapse
|
22
|
Shimoni A, Labopin M, Finke J, Ciceri F, Deconinck E, Kroger N, Gramatzki M, Stelljes M, Blaise D, Stölzel F, Chevallier P, Holler E, Fegueux N, Mohty M, Nagler A. The Role of Donor Selection for a Second Allogeneic Stem Cell Transplantation in Patients with AML Relapsing after a First Transplant; A Study on Behalf of the Acute Leukemia Working Party of EBMT. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
23
|
Phillipen L, Guenther A, Claviez A, Schrappe M, Repp R, Gramatzki M, Schub N. Treatment of Severe Acute GvHD with Alemtuzumab Is Effective without Increased Relapse Rates. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Tsamadou C, Fürst D, Rojewski M, Niederwieser D, Bunjes D, Neuchel C, Gramatzki M, Arnold R, Wagner E, Einsele H, Körper S, Schrezenmeier H, Mytilineos J. OR26. Investigating the impact of patient’s non-shared HLA-C Allotype expression levels in A 9/10 Single HLA-C mismatched hematopoieticstem cell transplantationsetting using two different HLA-C Expression proxy models. Hum Immunol 2018. [DOI: 10.1016/j.humimm.2018.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
25
|
Caers J, Garderet L, Kortüm KM, O'Dwyer ME, van de Donk NWCJ, Binder M, Dold SM, Gay F, Corre J, Beguin Y, Ludwig H, Larocca A, Driessen C, Dimopoulos MA, Boccadoro M, Gramatzki M, Zweegman S, Einsele H, Cavo M, Goldschmidt H, Sonneveld P, Delforge M, Auner HW, Terpos E, Engelhardt M. European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: what to use and when. Haematologica 2018; 103:1772-1784. [PMID: 30171031 PMCID: PMC6278986 DOI: 10.3324/haematol.2018.189159] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 08/27/2018] [Indexed: 01/04/2023] Open
Abstract
The diagnosis of multiple myeloma can be challenging, even for experienced physicians, and requires close collaboration between numerous disciplines (orthopedics, radiology, nuclear medicine, radiation therapy, hematology and oncology) before the final diagnosis of myeloma is made. The definition of multiple myeloma is based on the presence of clinical, biochemical, histopathological, and radiological markers of disease. Specific tests are needed both at presentation and during follow-up in order to reach the correct diagnosis and characterize the disease precisely. These tests can also serve prognostic purposes and are useful for follow-up of myeloma patients. Molecular analyses remain pivotal for defining high-risk myeloma and are used in updated patient stratifications, while minimal residual disease assessment via flow cytometry, molecular techniques and radiological approaches provides additional prognostic information on patients' long-term outcome. This pivotal information will guide our future treatment decisions in forthcoming clinical trials. The European Myeloma Network group updated their guidelines on different diagnostic recommendations, which should be of value to enable appropriate use of the recommendations both at diagnosis and during follow-up.
Collapse
Affiliation(s)
- Jo Caers
- Department of Hematology, University Hospital of Liege, Belgium .,Laboratory of Hematology, GIGA-I3, University of Liège, Belgium
| | | | - K Martin Kortüm
- Department of Internal Medicine II, University Hospital of Wuerzburg, Germany
| | - Michael E O'Dwyer
- Department of Hematology, National University of Ireland Galway, Ireland
| | | | - Mascha Binder
- Department of Internal Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra Maria Dold
- Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | - Francesca Gay
- Department of Hematology-Oncology, University Hospital Città della Salute e della Scienza, Torino, Italy
| | - Jill Corre
- Unit for Genomics in Myeloma, Institut Universitaire du Cancer - Oncopole, Toulouse, France
| | - Yves Beguin
- Department of Hematology, University Hospital of Liege, Belgium.,Laboratory of Hematology, GIGA-I3, University of Liège, Belgium
| | - Heinz Ludwig
- Wilhelminen Cancer Research Institute, Vienna, Austria
| | - Alessandra Larocca
- Department of Hematology-Oncology, University Hospital Città della Salute e della Scienza, Torino, Italy
| | - Christoph Driessen
- Department of Oncology and Hematology, Cantonal Hospital St. Gallen, Switzerland
| | | | - Mario Boccadoro
- Department of Hematology-Oncology, University Hospital Città della Salute e della Scienza, Torino, Italy
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Germany
| | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital of Wuerzburg, Germany
| | - Michele Cavo
- Seragnoli 'Institute of Hematology, Bologna University School of Medicine, Italy
| | - Hartmut Goldschmidt
- Department of Hematology, Rheumatology and Oncology, University Hospital Heidelberg, Germany.,National Center for Tumor Diseases, Heidelberg Medical University, Germany
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Michel Delforge
- Department of Hematology, University Hospital Leuven, Belgium
| | - Holger W Auner
- Centre for Haematology, Hammersmith Hospital, Imperial College London, UK
| | - Evangelos Terpos
- School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Monika Engelhardt
- Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| |
Collapse
|
26
|
Bringhen S, Milan A, Ferri C, Wäsch R, Gay F, Larocca A, Salvini M, Terpos E, Goldschmidt H, Cavo M, Petrucci MT, Ludwig H, Auner HW, Caers J, Gramatzki M, Boccadoro M, Einsele H, Sonneveld P, Engelhardt M. Cardiovascular adverse events in modern myeloma therapy - Incidence and risks. A review from the European Myeloma Network (EMN) and Italian Society of Arterial Hypertension (SIIA). Haematologica 2018; 103:1422-1432. [PMID: 30049825 PMCID: PMC6119131 DOI: 10.3324/haematol.2018.191288] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/05/2018] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular disease in patients with multiple myeloma may derive from factors unrelated to the disease (age, diabetes, dyslipidemia, obesity, prior cardiovascular diseases), related to the disease (cardiac AL-amyloidosis, hyperviscosity, high-output failure, arteriovenous shunting, anemia, renal dysfunction) and/or related to anti-myeloma treatment (anthracyclines, corticosteroids, alkylating agents, immunomodulatory drugs, proteasome inhibitors). Good knowledge of cardiovascular events, effective dose reductions, prevention and management of early and late cardiovascular side effects of chemotherapeutic agents are essential in current clinical practice. Myeloma experts are obliged to carefully balance the efficacy and toxicity of drugs for each individual patient. This review summarizes current data and novel insights into cardiovascular adverse events of today’s anti-myeloma treatment, focusing on carfilzomib, as a starting point for developing consensus recommendations on preventing and managing cardiovascular side effects in patients with multiple myeloma.
Collapse
Affiliation(s)
- Sara Bringhen
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Alberto Milan
- Department of Medical Sciences, Internal Medicine and Hypertension Division, University of Torino, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Italy; Rete Oncologica Piemontese, Italy
| | - Claudio Ferri
- University of L'Aquila, MeSVA Department, San Salvatore Hospital, Division of Internal Medicine & Nephrology, Coppito, Italy
| | - Ralph Wäsch
- Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | - Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Alessandra Larocca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Marco Salvini
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Evangelos Terpos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Greece
| | - Hartmut Goldschmidt
- Medizinische Klinik, Abteilung Innere Medizin V, Universitätsklinikum Heidelberg und National Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany
| | - Michele Cavo
- "Seràgnoli" Institute of Hematology and Medical Oncology, University of Bologna, Italy
| | - Maria Teresa Petrucci
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Italy
| | - Heinz Ludwig
- 1. Medical Department and Oncology, Wilhelminenspital Wien, Austria
| | | | - Jo Caers
- Department of Hematology, Domaine University, Liege, Belgium
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Germany
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital of Würzburg, Germany
| | | | - Monika Engelhardt
- Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | | |
Collapse
|
27
|
Avivi I, Arcaini L, Ferretti VV, Boumendil A, Finel H, Milone G, Zaja F, Liliana D, Musso M, Didier B, Bachy E, Wattad M, Nicolas-Virelizier E, Gramatzki M, Bourhis JH, Caillot D, Haenel A, Held G, Thieblemont C, Jindra P, Pohlreich D, Guilhot F, Kroschinsky F, Wahlin B, Scheid C, Ifrah N, Berthou C, Dreger P, Montoto S, Conconi A. High-dose therapy and autologous stem cell transplantation in marginal zone lymphomas: a retrospective study by the EBMT Lymphoma Working Party and FIL-GITMO. Br J Haematol 2018; 182:807-815. [PMID: 29984825 DOI: 10.1111/bjh.15454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/18/2018] [Indexed: 12/26/2022]
Abstract
The role of autologous stem cell transplantation (ASCT) in patients with marginal zone lymphoma (MZL) is debatable. This study investigated the outcome and prognostic factors affecting the outcome of patients undergoing ASCT for MZL. Eligible patients had non-transformed nodal, extra-nodal (MALT) or splenic MZL (SMZL), aged ≥18 years, who underwent a first ASCT between1994 and 2013 and were reported to the European Society for Blood and Marrow Transplantation, Fondazione Italiana Linfomi or Gruppo Italiano Trapianto Di Midollo Osseo registries. The study included 199 patients, [111 MALT lymphoma, 55 nodal MZL (NMZL) and 33 SMZL]. Median age at transplantation was 56 years. The median number of prior therapies was 2 (range 1-8), including rituximab in 71%. 95% had chemosensitive disease. 89% received a chemotherapy-based high-dose regimen. There were no significant differences in patient and transplant characteristics between the 3 histological subtypes except for a lower percentage of patients previously treated with rituximab in the MALT sub-group and more transplants performed in recent years in the other sub-groups. After a median follow-up of 5 years, 5-year cumulative incidence of relapse/progression and non-relapse mortality were 38% and 9%, respectively. Five-year event-free survival (EFS) and overall survival (OS) were 53% and 73%, respectively. Five-year cumulative incidence of second malignancies was 6%. Multivariate analysis revealed age ≥65 years was associated with a shorter EFS and OS. In addition, patients with SMZL had a shorter OS than those with MALT. ASCT may provide clinical benefit in MZL patients who have failed multiple lines of chemoimmunotherapy.
Collapse
Affiliation(s)
- Irit Avivi
- Tel Aviv Sourasky Medical Centre, Tel-Aviv, Israel
| | - Luca Arcaini
- Universita Di Pavia, IRCCS Fondazione San Matteo, Pavia, Italy
| | | | | | - Hervé Finel
- EBMT LWP Paris Office, Hôpital Saint-Antoine, Paris, France
| | - Giuseppe Milone
- Institute of Hematology, University of Catania, Catania, Italy
| | | | - Devizzi Liliana
- Division of Medical Oncology, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Blaise Didier
- Département d'Onco-Hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Emmanuel Bachy
- National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | | | | | - Martin Gramatzki
- University Hospital Schleswig-Holstein, Kiel, Germany.,University of Kiel, Kiel, Germany
| | | | | | | | - Gerhard Held
- Department of Internal Medicine I, Saarland University Medical School, Homburg/Saar, Germany.,University Hospital of Saarland, Homburg, Germany
| | - Catherine Thieblemont
- APHP - INSERM U 728 - Institut Universitaire d'Hematologie, Hopital Saint-Louis, Paris, France
| | | | | | | | - Frank Kroschinsky
- Midizinische Klinik und Poliklinik I, Universitaetsklinikum Dresden, Dresden, Germany
| | - Björn Wahlin
- Department of Medicine, Huddinge (MedH), H7, Unit for Hematology, M 54, Karolinska Universitetssjukhuset Huddinge, Stockholm, Sweden
| | | | | | | | - Peter Dreger
- EBMT LWP Paris Office, Hôpital Saint-Antoine, Paris, France.,University of Heidelberg, Heidelberg, Germany
| | - Silvia Montoto
- Department of Haemato-Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | | |
Collapse
|
28
|
Gramatzki M, Guenther A, Offidani M, Engelhardt MM, Montefusco V, Patriarca F, Angelucci E, Salvini M, Pönisch W, Spada S, Gentili S, Wäsch R, Schub N, Corradini P, Einsele H, Sonneveld P, Boccadoro M, Gay FM. Carfilzomib, bendamustine, and dexamethasone (KBd) in advanced multiple myeloma: The EMN09-trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.8019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - Andreas Guenther
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - Massimo Offidani
- Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | | | - Vittorio Montefusco
- Division of Hematology, National Tumor Institute, University of Milano, Milano, Italy
| | | | - Emanuele Angelucci
- Hematology Department, National Cancer Research Institute, Genova, Italy
| | - Marco Salvini
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | - Wolfram Pönisch
- Department of Hematology, University of Leipzig, Leipzig, Germany
| | - Stefano Spada
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | - Silvia Gentili
- Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Ralph Wäsch
- Department for Hematology and Oncology, University of Freiburg, Freiburg, Germany
| | - Natalie Schub
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - Paolo Corradini
- Division of Hematology, National Tumor Institute, University of Milano, Milano, Italy
| | - Hermann Einsele
- Department of Medicine 2, University Hospital of Würzburg, Würzburg, Germany
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | | |
Collapse
|
29
|
Oberg HH, Kellner C, Gonnermann D, Sebens S, Bauerschlag D, Gramatzki M, Kabelitz D, Peipp M, Wesch D. Tribody [(HER2) 2xCD16] Is More Effective Than Trastuzumab in Enhancing γδ T Cell and Natural Killer Cell Cytotoxicity Against HER2-Expressing Cancer Cells. Front Immunol 2018; 9:814. [PMID: 29725336 PMCID: PMC5916959 DOI: 10.3389/fimmu.2018.00814] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/04/2018] [Indexed: 12/31/2022] Open
Abstract
An enhanced expression of human epidermal growth factor receptor 2 (HER2, ErbB2) often occurs in an advanced stage of breast, ovarian, gastric or esophageal cancer, and pancreatic ductal adenocarcinoma (PDAC). Commonly, HER2 expression is associated with poor clinical outcome or chemoresistance in ovarian and breast cancer patients. Treatment with humanized anti-HER2 monoclonal antibodies, such as trastuzumab or pertuzumab, has improved the outcome of patients with HER2-positive metastatic gastric or breast cancer, but not all patients benefit. In this study, the bispecific antibody [(HER2)2xCD16] in the tribody format was employed to re-direct CD16-expressing γδ T lymphocytes as well as natural killer (NK) cells to the tumor-associated cell surface antigen HER2 to enhance their cytotoxic anti-tumor activity. Tribody [(HER2)2xCD16] comprises two HER2-specific single chain fragment variable fused to a fragment antigen binding directed to the CD16 (FcγRIII) antigen expressed on γδ T cells and NK cells. Our results revealed the superiority of tribody [(HER2)2xCD16] compared to trastuzumab in triggering γδ T cell and NK cell-mediated lysis of HER2-expressing tumor cells, such as PDAC, breast cancer, and autologous primary ovarian tumors. The increased efficacy of [(HER2)2xCD16] can be explained by an enhanced degranulation of immune cells. Although CD16 expression was decreased on γδ T cells in several PDAC patients and the number of tumor-infiltrating NK cells and γδ T cells was impaired in ovarian cancer patients, [(HER2)2xCD16] selectively enhanced cytotoxicity of cells from these patients. Here, unique anti-tumor properties of tribody [(HER2)2xCD16] are identified which beyond addressing HER2 overexpressing solid tumors may allow to treat with similar immunoconstructs combined with the adoptive transfer of γδ T cells and NK cells refractory hematological malignancies. A major advantage of γδ T cells and NK cells in the transplant situation of refractory hematological malignancies is given by their HLA-independent killing and a reduced graft-versus-host disease.
Collapse
Affiliation(s)
- Hans H Oberg
- Institute of Immunology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Christian Kellner
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Daniel Gonnermann
- Institute of Immunology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Susanne Sebens
- Institute for Experimental Cancer Research, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Dirk Bauerschlag
- Clinic of Gynecology and Obstetrics, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Dieter Kabelitz
- Institute of Immunology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| | - Daniela Wesch
- Institute of Immunology, University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts University (CAU) of Kiel, Kiel, Germany
| |
Collapse
|
30
|
Kellner C, Peipp M, Gramatzki M, Schrappe M, Schewe DM. Perspectives of Fc engineered antibodies in CD19 targeting immunotherapies in pediatric B-cell precursor acute lymphoblastic leukemia. Oncoimmunology 2018; 7:e1448331. [PMID: 30221037 PMCID: PMC6136853 DOI: 10.1080/2162402x.2018.1448331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/08/2018] [Accepted: 02/28/2018] [Indexed: 12/18/2022] Open
Abstract
CD19 immunotherapies based on T cells opened new avenues in the treatment of pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL). However, Fc engineered CD19 antibodies may also bear great potential. In light of recent preclinical and clinical data, perspectives of such antibodies designed for improved effectiveness in BCP-ALL are presented.
Collapse
Affiliation(s)
- Christian Kellner
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian Albrechts University of Kiel, Kiel, Germany, and University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian Albrechts University of Kiel, Kiel, Germany, and University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian Albrechts University of Kiel, Kiel, Germany, and University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Martin Schrappe
- Pediatric Hematology/Oncology, ALL-BFM Study Group, Christian Albrechts University of Kiel, Kiel, Germany, and University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Denis M. Schewe
- Pediatric Hematology/Oncology, ALL-BFM Study Group, Christian Albrechts University of Kiel, Kiel, Germany, and University Hospital Schleswig-Holstein, Campus Kiel, Germany
| |
Collapse
|
31
|
Schrell U, Buchfelder M, Hensen J, Wendler J, Gramatzki M, Wolf F, Becker W. Somatostatin Receptor Expression in the Thyroid Demonstrated with 111In-Octreotide Scintigraphy. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1629763] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryNeuroendocrine tumors with somatostatin receptor expression may be localized by 111ln-octreotide scintigraphy. This study examines those thyroid conditions where 111 ln-octreotide uptake could be observed also in the thyroid gland. 26 consecutive patients who underwent 111 ln-octreotide scintigraphy for tumor localization were additionally examined for thyroid disease by sonography and 99mTc-pertechnetate scintigraphy. 12 of these patients had no significant thyroid uptake and had an euthyroid normal-sized thyroid gland. 14 patiens with 111ln thyroid uptakes had endemic goiters, two of them with thyroid autonomy and one with Graves’ disease. Thus, 111 ln-octreotide thyroid uptake was predominantly seen in patients with endemic goiter with or without thyroid autonomy.
Collapse
|
32
|
Gay F, Engelhardt M, Terpos E, Wäsch R, Giaccone L, Auner HW, Caers J, Gramatzki M, van de Donk N, Oliva S, Zamagni E, Garderet L, Straka C, Hajek R, Ludwig H, Einsele H, Dimopoulos M, Boccadoro M, Kröger N, Cavo M, Goldschmidt H, Bruno B, Sonneveld P. From transplant to novel cellular therapies in multiple myeloma: European Myeloma Network guidelines and future perspectives. Haematologica 2018; 103:197-211. [PMID: 29217780 PMCID: PMC5792264 DOI: 10.3324/haematol.2017.174573] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 12/05/2017] [Indexed: 12/20/2022] Open
Abstract
Survival of myeloma patients has greatly improved with the use of autologous stem cell transplantation and novel agents, such as proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies. Compared to bortezomib- and lenalidomide-based regimens alone, the addition of high-dose melphalan followed by autologous transplantation significantly improves progression-free survival, although an overall survival benefit was not observed in all trials. Moreover, follow up of recent trials is still too short to show any difference in survival. In the light of these findings, novel agent-based induction followed by autologous transplantation is considered the standard upfront treatment for eligible patients (level of evidence: 1A). Post-transplant consolidation and maintenance treatment can further improve patient outcome (1A). The availability of several novel agents has led to the development of multiple combination regimens such as salvage treatment options. In this context, the role of salvage autologous transplantation and allotransplant has not been extensively evaluated. In the case of prolonged remission after upfront autologous transplantation, another autologous transplantation at relapse can be considered (2B). Patients who experience early relapse and/or have high-risk features have a poor prognosis and may be considered as candidates for clinical trials that, in young and fit patients, may also include an allograft in combination with novel agents (2B). Ongoing studies are evaluating the role of novel cellular therapies, such as inclusion of antibody-based triplets and quadruplets, and chimeric antigen receptor-T cells. Despite encouraging preliminary results, longer follow up and larger patient numbers are needed before the clinical use of these novel therapies can be widely recommended.
Collapse
Affiliation(s)
- Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda-Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Monika Engelhardt
- Universitätsklinikum Freiburg, Medical Department, Hematology, Oncology & Stem Cell Transplantation, Freiburg, Germany
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Greece
| | - Ralph Wäsch
- Universitätsklinikum Freiburg, Medical Department, Hematology, Oncology & Stem Cell Transplantation, Freiburg, Germany
| | - Luisa Giaccone
- Department of Oncology, A.O.U Città della Salute e della Scienza di Torino, and Department of Molecular Biotechnology and Health Sciences, University of Torino, Italy
| | - Holger W Auner
- Centre for Haematology, Department of Medicine, Imperial College London, UK
| | - Jo Caers
- Department of Clinical Hematology, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman, Liège, Belgium
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2 Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Niels van de Donk
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Stefania Oliva
- Myeloma Unit, Division of Hematology, University of Torino, Azienda-Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Elena Zamagni
- Seragnoli Institute of Hematology, Bologna University School of Medicine, Italy
| | - Laurent Garderet
- INSERM, UMR_S 938, Proliferation and Differentiation of Stem Cells, Paris, AP-HP, Hôpital Saint Antoine, Département d'Hématologie et de Thérapie Cellulaire; Sorbonne Universités, UPMC Univ Paris 06, France
| | | | - Roman Hajek
- Department of Hematooncology, University Hospital Ostrava, Czech Republic and Faculty of Medicine University of Ostrava, Czech Republic
| | - Heinz Ludwig
- Wilhelminen Cancer Research Institute, c/o Department of Medicine I, Center of Oncology, Hematology and Palliative Care, Vienna, Austria
| | - Herman Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Germany
| | - Meletios Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Greece
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda-Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Nicolaus Kröger
- Department of Stem cell Transplantation, University Medical Center Hamburg-Eppendorf, Germany
| | - Michele Cavo
- Seragnoli Institute of Hematology, Bologna University School of Medicine, Italy
| | - Hartmut Goldschmidt
- Medizinische Klinik, Abteilung Innere Medizin V, Universitätsklinikum Heidelberg und National Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany
| | - Benedetto Bruno
- Department of Oncology, A.O.U Città della Salute e della Scienza di Torino, and Department of Molecular Biotechnology and Health Sciences, University of Torino, Italy
| | - Pieter Sonneveld
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
33
|
Schmid C, de Wreede LC, van Biezen A, Finke J, Ehninger G, Ganser A, Volin L, Niederwieser D, Beelen D, Alessandrino P, Kanz L, Schleuning M, Passweg J, Veelken H, Maertens J, Cornelissen JJ, Blaise D, Gramatzki M, Milpied N, Yakoub-Agha I, Mufti G, Rovira M, Arnold R, de Witte T, Robin M, Kröger N. Outcome after relapse of myelodysplastic syndrome and secondary acute myeloid leukemia following allogeneic stem cell transplantation: a retrospective registry analysis on 698 patients by the Chronic Malignancies Working Party of the European Society of Blood and Marrow Transplantation. Haematologica 2017; 103:237-245. [PMID: 29101205 PMCID: PMC5792268 DOI: 10.3324/haematol.2017.168716] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 10/30/2017] [Indexed: 11/09/2022] Open
Abstract
No standard exists for the treatment of myelodysplastic syndrome relapsing after allogeneic stem cell transplantation. We performed a retrospective registry analysis of outcomes and risk factors in 698 patients, treated with different strategies. The median overall survival from relapse was 4.7 months (95% confidence interval: 4.1-5.3) and the 2-year survival rate was 17.7% (95% confidence interval: 14.8-21.2%). Shorter remission after transplantation (P<0.001), advanced disease (P=0.001), older age (P=0.007), unrelated donor (P=0.008) and acute graft-versus-host disease before relapse (P<0.001) adversely influenced survival. At 6 months from relapse, patients had received no cellular treatment, (i.e. palliative chemotherapy or best supportive care, n=375), donor lymphocyte infusion (n=213), or a second transplant (n=110). Treatment groups were analyzed separately because of imbalanced characteristics and difficulties in retrospectively evaluating the reason for individual treatments. Of the patients who did not receive any cellular therapy, 109 were alive at 6 months after relapse, achieving a median overall survival from this landmark of 8.9 months (95% confidence interval: 5.1-12.6). Their 2-year survival rate was 29.7%. Recipients of donor lymphocytes achieved a median survival from first infusion of 6.0 months (95% confidence interval: 3.7-8.3) with a 2-year survival rate of 27.6%. Longer remission after first transplantation (P<0.001) and younger age (P=0.009) predicted better outcome. Among recipients of a second transplant, the median survival from second transplantation was 4.2 months (95% confidence interval: 2.5-5.9), and their 2-year survival rate was 17.0%. Longer remission after first transplantation (P<0.001), complete remission at second transplant (P=0.008), no prior chronic graft-versus-host disease (P<0.001) and change to a new donor (P=0.04) predicted better outcome. The data enabled identification of patients benefiting from donor lymphocyte infusion and second transplantation, and may serve as a baseline for prospective trials.
Collapse
Affiliation(s)
- Christoph Schmid
- Department of Hematology and Oncology, Klinikum Augsburg, University of Munich, Augsburg, Germany
| | - Liesbeth C de Wreede
- Department of Medical Statistics & Bioinformatics, Leiden University Medical Center, the Netherlands.,DKMS, German Bone Marrow Donor Center, Germany
| | - Anja van Biezen
- Department of Medical Statistics & Bioinformatics, Leiden University Medical Center, the Netherlands
| | - Jürgen Finke
- Department of Medicine 1, Hematology and Oncology, University of Freiburg, Germany
| | - Gerhard Ehninger
- Medizinische Klinik und Poliklinik I, Universitaets-Klinikum Dresden, Germany
| | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Germany
| | - Liisa Volin
- Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Center, Helsinki, Finland
| | - Dietger Niederwieser
- Division of Hematology, Oncology and Hemostaseology, University Hospital Leipzig, Germany
| | - Dietrich Beelen
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - Paolo Alessandrino
- Clinica Ematologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lothar Kanz
- Medizinische Klinik II, Universität Tübingen, Germany
| | | | - Jakob Passweg
- Department of Hematology, University Hospital, Basel, Switzerland
| | - Hendrik Veelken
- BMT Center Leiden, Leiden University Hospital, the Netherlands
| | - Johan Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Jan J Cornelissen
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Didier Blaise
- Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein Campus, Kiel, Germany
| | - Noel Milpied
- CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France
| | | | - Ghulam Mufti
- Department of Hematological Medicine, GKT School of Medicine, London, UK
| | - Montserrat Rovira
- Institute of Hematology & Oncology, Hospital Clinic, Barcelona, Spain
| | - Renate Arnold
- Medizinische Klinik m. S. Hämatologie/Onkologie, Charité Universitätsmedizin Berlin, Germany
| | - Theo de Witte
- Department of Tumor Immunology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie Robin
- Department of Hematology - BMT, Hôspital St. Louis, Paris, France
| | - Nikolaus Kröger
- Department of Stem Cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| |
Collapse
|
34
|
Tsamadou C, Fürst D, Vucinic V, Bunjes D, Neuchel C, Mytilineos D, Gramatzki M, Arnold R, Wagner EM, Einsele H, Müller C, Schrezenmeier H, Mytilineos J. Human leukocyte antigen-E mismatch is associated with better hematopoietic stem cell transplantation outcome in acute leukemia patients. Haematologica 2017; 102:1947-1955. [PMID: 28883078 PMCID: PMC5664399 DOI: 10.3324/haematol.2017.169805] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/04/2017] [Indexed: 01/18/2023] Open
Abstract
The immunomodulatory role of human leukocyte antigen (HLA)-E in hematopoietic stem cell transplantation (HSCT) has not been extensively investigated. To this end, we genotyped 509 10/10 HLA unrelated transplant pairs for HLA-E, in order to study the effect of HLA-E as a natural killer (NK)-alloreactivity mediator on HSCT outcome in an acute leukemia (AL) setting. Overall survival (OS), disease free survival (DFS), relapse incidence (RI) and non-relapse mortality (NRM) were set as endpoints. Analysis of our data revealed a significant correlation between HLA-E mismatch and improved HSCT outcome, as shown by both univariate (53% vs 38%, P=0.002, 5-year OS) and multivariate (hazard ratio (HR)=0.63, confidence interval (CI) 95%=0.48-0.83, P=0.001) analyses. Further subgroup analysis demonstrated that the positive effect of HLA-E mismatch was significant and pronounced in advanced disease patients (n=120) (5-year OS: 50% vs 18%, P=0.005; HR=0.40, CI 95%=0.22-0.72, P=0.002; results from univariate and multivariate analyses, respectively). The study herein is the first to report an association between HLA-E incompatibility and improved post-transplant prognosis in AL patients who have undergone matched unrelated HSCT. Combined NK and T cell HLA-E-mediated mechanisms may account for the better outcomes observed. Notwithstanding the necessity for in vitro and confirmational studies, our findings highlight the clinical relevance of HLA-E matching and strongly support prospective HLA-E screening upon donor selection for matched AL unrelated HSCTs.
Collapse
MESH Headings
- Adolescent
- Adult
- Aged
- Alleles
- Bone Marrow Transplantation
- Female
- Genotype
- Hematopoietic Stem Cell Transplantation/adverse effects
- Hematopoietic Stem Cell Transplantation/methods
- Histocompatibility Antigens Class I/genetics
- Histocompatibility Antigens Class I/immunology
- Histocompatibility Testing
- Humans
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/therapy
- Male
- Middle Aged
- Potassium Channels, Inwardly Rectifying/genetics
- Prognosis
- Survival Analysis
- Transplantation Conditioning
- Transplantation, Homologous
- Treatment Outcome
- Young Adult
- HLA-E Antigens
Collapse
Affiliation(s)
- Chrysanthi Tsamadou
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, and University Hospital Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Germany
| | - Daniel Fürst
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, and University Hospital Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Germany
| | - Vladan Vucinic
- Department of Hematology/Oncology, University of Leipzig, Germany
| | - Donald Bunjes
- Department of Internal Medicine III, University of Ulm, Germany
| | - Christine Neuchel
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, and University Hospital Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Germany
| | | | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2 Department of Medicine, University of Kiel, Germany
| | - Renate Arnold
- Hematology/Oncology Department, Charité Campus Virchow-Klinikum, Berlin, Germany
| | - Eva Maria Wagner
- Department of Internal Medicine III, Johannes Gutenberg-University Mainz, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Germany
| | - Carlheinz Müller
- ZKRD - Zentrale Knochenmarkspender-Register für Deutschland, German National Bone Marrow Donor Registry, Germany
- DRST - German Registry for Stem Cell Transplantation, Ulm, Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, and University Hospital Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Germany
| | - Joannis Mytilineos
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, and University Hospital Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Germany
- DRST - German Registry for Stem Cell Transplantation, Ulm, Germany
| |
Collapse
|
35
|
Peipp M, Wesch D, Oberg HH, Lutz S, Muskulus A, van de Winkel JGJ, Parren PWHI, Burger R, Humpe A, Kabelitz D, Gramatzki M, Kellner C. CD20-Specific Immunoligands Engaging NKG2D Enhance γδ T Cell-Mediated Lysis of Lymphoma Cells. Scand J Immunol 2017; 86:196-206. [PMID: 28708284 DOI: 10.1111/sji.12581] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/25/2017] [Indexed: 02/02/2023]
Abstract
Human γδ T cells are innate-like T cells which are able to kill a broad range of tumour cells and thus may have potential for cancer immunotherapy. The activating receptor natural killer group 2 member D (NKG2D) plays a key role in regulating immune responses driven by γδ T cells. Here, we explored whether recombinant immunoligands consisting of a CD20 single-chain fragment variable (scFv) linked to a NKG2D ligand, either MHC class I chain-related protein A (MICA) or UL16 binding protein 2 (ULBP2), could be employed to engage γδ T cells for tumour cell killing. The two immunoligands, designated MICA:7D8 and ULBP2:7D8, respectively, enhanced cytotoxicity of ex vivo-expanded γδ T cells against CD20-positive lymphoma cells. Both Vδ1 and Vδ2 γδ T cells were triggered by MICA:7D8 or ULBP2:7D8. Killing of CD20-negative tumour cells was not induced by the immunoligands, indicating their antigen specificity. MICA:7D8 and ULBP2:7D8 acted in a dose-dependent manner and induced cytotoxicity at nanomolar concentrations. Importantly, chronic lymphocytic leukaemia (CLL) cells isolated from patients were sensitized by the two immunoligands for γδ T cell cytotoxicity. In a combination approach, the immunoligands were combined with bromohydrin pyrophosphate (BrHPP), an agonist for Vδ2 γδ T cells, which further enhanced the efficacy in target cell killing. Thus, employing tumour-directed recombinant immunoligands which engage NKG2D may represent an attractive strategy to enhance antitumour cytotoxicity of γδ T cells.
Collapse
Affiliation(s)
- M Peipp
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - D Wesch
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - H-H Oberg
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - S Lutz
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - A Muskulus
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - J G J van de Winkel
- Immunotherapy Laboratory, Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.,Genmab, Utrecht, The Netherlands
| | - P W H I Parren
- Genmab, Utrecht, The Netherlands.,Department of Cancer and Inflammation Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - R Burger
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - A Humpe
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - D Kabelitz
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - C Kellner
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| |
Collapse
|
36
|
Einsele H, Engelhardt M, Tapprich C, Müller J, Liebisch P, Langer C, Kropff M, Mügge LO, Jung W, Wolf HH, Metzner B, Hart C, Gramatzki M, Hertenstein B, Pfreundschuh M, Rösler W, Fischer T, Maschmeyer G, Kanz L, Hess G, Jäger E, Bentz M, Dürk HA, Salwender H, Hebart H, Straka C, Knop S. Phase II study of bortezomib, cyclophosphamide and dexamethasone as induction therapy in multiple myeloma: DSMM XI trial. Br J Haematol 2017; 179:586-597. [PMID: 28961309 DOI: 10.1111/bjh.14920] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/06/2017] [Indexed: 12/22/2022]
Abstract
We assessed the safety and efficacy of bortezomib, cyclophosphamide and dexamethasone (VCD) induction therapy in previously untreated multiple myeloma patients. A total of 414 patients received three 21-day cycles of VCD prior to autologous stem-cell transplantation (ASCT). Most common grade ≥3 adverse events were leucopenia (31·4%) and thrombocytopenia (6·8%). The overall response rate (ORR) by investigator-based assessment was 85·4%. Most patients (74%) underwent successful central laboratory-based molecular cytogenetic analysis. No clinically relevant differences in ORR post-induction were seen between patients with or without high-risk cytogenetic abnormalities (86·2% vs. 84·3%). Further follow-up data are available for 113 patients receiving ASCT who were included in a prospective consolidation trial (median follow-up, 55·5 months); median progression-free survival (PFS) was 35·3 months and median overall survival (OS) was not reached. In patients with high-risk versus standard-risk cytogenetics, median PFS was 19·9 vs. 43·6 months (P < 0·0001), and median OS was 54·7 months versus not reached (P = 0·0022). VCD is an effective and tolerable induction regimen; results suggest that VCD induces high response rates independently of cytogenetic risk status, but after long-term follow-up, cytogenetic high risk is associated with markedly reduced PFS and OS post-ASCT.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Wolfram Jung
- University Hospital Gottingen, Gottingen, Germany
| | | | - Bernd Metzner
- Klinikum Oldenburg, University Hospital, Oldenburg, Germany
| | | | | | | | | | - Wolf Rösler
- University Hospital Erlangen, Erlangen, Germany
| | | | | | - Lothar Kanz
- University Hospital Tübingen, Tübingen, Germany
| | - Georg Hess
- University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | | | | | - Holger Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | | | - Stefan Knop
- University Hospital Würzburg, Würzburg, Germany
| |
Collapse
|
37
|
Wirt T, Rosskopf S, Rösner T, Eichholz KM, Kahrs A, Lutz S, Kretschmer A, Valerius T, Klausz K, Otte A, Gramatzki M, Peipp M, Kellner C. An Fc Double-Engineered CD20 Antibody with Enhanced Ability to Trigger Complement-Dependent Cytotoxicity and Antibody-Dependent Cell-Mediated Cytotoxicity. Transfus Med Hemother 2017; 44:292-300. [PMID: 29070974 DOI: 10.1159/000479978] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/01/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Engineering of the antibody's fragment crystallizable (Fc) by modifying the amino acid sequence (Fc protein engineering) or the glycosylation pattern (Fc glyco-engineering) allows enhancing effector functions of tumor targeting antibodies. Here, we investigated whether complement-dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC) of CD20 antibodies could be improved simultaneously by combining Fc protein engineering and glyco-engineering technologies. METHODS AND RESULTS Four variants of the CD20 antibody rituximab were generated: a native IgG1, a variant carrying the EFTAE modification (S267E/H268F/S324T/G236A/I332E) for enhanced CDC as well as glyco-engineered, non-fucosylated derivatives of both to boost ADCC. The antibodies bound CD20 specifically with similar affinity. Antibodies with EFTAE modification were more efficacious in mediating CDC, irrespective of fucosylation, than antibodies with wild-type sequences due to enhanced C1q binding. In contrast, non-fucosylated variants had an enhanced affinity to FcγRIIIA and improved ADCC activity. Importantly, the double-engineered antibody lacking fucose and carrying the EFTAE modification mediated both CDC and ADCC with higher efficacy than the native CD20 IgG1 antibody. CONCLUSION Combining glyco-engineering and protein engineering technologies offers the opportunity to simultaneously enhance ADCC and CDC activities of therapeutic antibodies. This approach may represent an attractive strategy to further improve antibody therapy of cancer and deserves further evaluation.
Collapse
Affiliation(s)
- Tim Wirt
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sophia Rosskopf
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Thies Rösner
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Klara Marie Eichholz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Anne Kahrs
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sebastian Lutz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Anna Kretschmer
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Thomas Valerius
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Katja Klausz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Anna Otte
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christian Kellner
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, Christian-Albrechts-University of Kiel, Kiel, Germany
| |
Collapse
|
38
|
Klausz K, Cieker M, Kellner C, Oberg HH, Kabelitz D, Valerius T, Burger R, Gramatzki M, Peipp M. A novel Fc-engineered human ICAM-1/CD54 antibody with potent anti-myeloma activity developed by cellular panning of phage display libraries. Oncotarget 2017; 8:77552-77566. [PMID: 29100408 PMCID: PMC5652799 DOI: 10.18632/oncotarget.20641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 08/07/2017] [Indexed: 11/25/2022] Open
Abstract
To identify antibodies suitable for multiple myeloma (MM) immunotherapy, a cellular screening approach was developed using plasma cell lines JK-6L and INA-6 and human synthetic single-chain fragment variable (scFv) phage libraries. Isolated phage antibodies were screened for myeloma cell surface reactivity. Due to its binding characteristics, phage PIII-15 was selected to generate the scFv-Fc fusion protein TP15-Fc with an Fc domain optimized for FcγRIIIa binding. Various MM cell lines and patient-derived CD138-positive malignant plasma cells, but not granulocytes, B or T lymphocytes from healthy donors were recognized by TP15-Fc. Human intercellular adhesion molecule-1 (ICAM-1/CD54) was identified as target antigen by using transfected Chinese hamster ovary (CHO) cells. Of note, no cross-reactivity of TP15-Fc with mouse ICAM-1 transfected cells was detected. TP15-Fc was capable to induce antibody-dependent cell-mediated cytotoxicity (ADCC) against different human plasma cell lines and patients' myeloma cells with peripheral blood mononuclear cells (PBMC) and purified NK cells. Importantly, TP15-Fc showed potent in vivo efficacy and completely prevented growth of human INA-6.Tu1 plasma cells in a xenograft SCID/beige mouse model. Thus, the novel ADCC-optimized TP15-Fc exerts potent anti-myeloma activity and has promising characteristics to be further evaluated for MM immunotherapy.
Collapse
Affiliation(s)
- Katja Klausz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Michael Cieker
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christian Kellner
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Hans-Heinrich Oberg
- Institute of Immunology, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dieter Kabelitz
- Institute of Immunology, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Thomas Valerius
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Renate Burger
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein and Christian-Albrechts-University Kiel, Kiel, Germany
| |
Collapse
|
39
|
Binder S, Hösler N, Riedel D, Zipfel I, Buschmann T, Kämpf C, Reiche K, Burger R, Gramatzki M, Hackermüller J, Stadler PF, Horn F. STAT3-induced long noncoding RNAs in multiple myeloma cells display different properties in cancer. Sci Rep 2017; 7:7976. [PMID: 28801664 PMCID: PMC5554185 DOI: 10.1038/s41598-017-08348-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/10/2017] [Indexed: 12/31/2022] Open
Abstract
Interleukin-6 (IL-6)-activated Signal Transducer and Activator of Transcription 3 (STAT3) facilitates survival in the multiple myeloma cell line INA-6 and therefore represents an oncogenic key player. However, the biological mechanisms are still not fully understood. In previous studies we identified microRNA-21 as a STAT3 target gene with strong anti-apoptotic potential, suggesting that noncoding RNAs have an impact on the pathogenesis of human multiple myeloma. Here, we describe five long noncoding RNAs (lncRNAs) induced by IL-6-activated STAT3, which we named STAiRs. While STAiRs 1, 2 and 6 remain unprocessed in the nucleus and show myeloma-specific expression, STAiRs 15 and 18 are spliced and broadly expressed. Especially STAiR2 and STAiR18 are promising candidates. STAiR2 originates from the first intron of a tumor suppressor gene. Our data support a mutually exclusive expression of either STAiR2 or the functional tumor suppressor in INA-6 cells and thus a contribution of STAiR2 to tumorigenesis. Furthermore, STAiR18 was shown to be overexpressed in every tested tumor entity, indicating its global role in tumor pathogenesis. Taken together, our study reveals a number of STAT3-induced lncRNAs suggesting that the interplay between the coding and noncoding worlds represents a fundamental principle of STAT3-driven cancer development in multiple myeloma and beyond.
Collapse
Affiliation(s)
- Stefanie Binder
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, Leipzig, Germany.
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany.
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
| | - Nadine Hösler
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Diana Riedel
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
| | - Ivonne Zipfel
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
| | - Tilo Buschmann
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
- The RIBOLUTION Consortium, Leipzig, Germany
| | - Christoph Kämpf
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
- Young Investigators Group Bioinformatics and Transcriptomics, Department Proteomics, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
- Bioinformatics Group, Department of Computer Science, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Kristin Reiche
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
- The RIBOLUTION Consortium, Leipzig, Germany
- Young Investigators Group Bioinformatics and Transcriptomics, Department Proteomics, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Renate Burger
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine 2, Christian-Albrechts-University, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine 2, Christian-Albrechts-University, Kiel, Germany
| | - Jörg Hackermüller
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
- Young Investigators Group Bioinformatics and Transcriptomics, Department Proteomics, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
- Department of Computer Science, University of Leipzig, Leipzig, Germany
| | - Peter F Stadler
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
- Bioinformatics Group, Department of Computer Science, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Interdisciplinary Center for Bioinformatics, University of Leipzig, Leipzig, Germany
- German Centre for Integrative Biodiversity Research - iDiv, Halle-Jena-Leipzig, Germany
- Max Planck Institute for Mathematics in the Sciences, Leipzig, Germany
- Department of Theoretical Chemistry, University of Vienna, Vienna, Austria
- Center for RNA in Technology and Health, University of Copenhagen, Copenhagen, Denmark
- Santa Fe Institute, Santa Fe, USA
| | - Friedemann Horn
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
- The RIBOLUTION Consortium, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| |
Collapse
|
40
|
Brissot E, Labopin M, Stelljes M, Ehninger G, Schwerdtfeger R, Finke J, Kolb HJ, Ganser A, Schäfer-Eckart K, Zander AR, Bunjes D, Mielke S, Bethge WA, Milpied N, Kalhs P, Blau IW, Kröger N, Vitek A, Gramatzki M, Holler E, Schmid C, Esteve J, Mohty M, Nagler A. Comparison of matched sibling donors versus unrelated donors in allogeneic stem cell transplantation for primary refractory acute myeloid leukemia: a study on behalf of the Acute Leukemia Working Party of the EBMT. J Hematol Oncol 2017; 10:130. [PMID: 28646908 PMCID: PMC5483262 DOI: 10.1186/s13045-017-0498-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/16/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Primary refractory acute myeloid leukemia (PRF-AML) is associated with a dismal prognosis. Allogeneic stem cell transplantation (HSCT) in active disease is an alternative therapeutic strategy. The increased availability of unrelated donors together with the significant reduction in transplant-related mortality in recent years have opened the possibility for transplantation to a larger number of patients with PRF-AML. Moreover, transplant from unrelated donors may be associated with stronger graft-mediated anti-leukemic effect in comparison to transplantations from HLA-matched sibling donor, which may be of importance in the setting of PRF-AML. METHODS The current study aimed to address the issue of HSCT for PRF-AML and to compare the outcomes of HSCT from matched sibling donors (n = 660) versus unrelated donors (n = 381), for patients with PRF-AML between 2000 and 2013. The Kaplan-Meier estimator, the cumulative incidence function, and Cox proportional hazards regression models were used where appropriate. RESULTS HSCT provide patients with PRF-AML a 2-year leukemia-free survival and overall survival of about 25 and 30%, respectively. In multivariate analysis, two predictive factors, cytogenetics and time from diagnosis to transplant, were associated with lower leukemia-free survival, whereas Karnofsky performance status at transplant ≥90% was associated with better leukemia-free survival (LFS). Concerning relapse incidence, cytogenetics and time from diagnosis to transplant were associated with increased relapse. Reduced intensity conditioning regimen was the only factor associated with lower non-relapse mortality. CONCLUSIONS HSCT was able to rescue about one quarter of the patients with PRF-AML. The donor type did not have any impact on PRF patients' outcomes. In contrast, time to transplant was a major prognostic factor for LFS. For patients with PRF-AML who do not have a matched sibling donor, HSCT from an unrelated donor is a suitable option, and therefore, initiation of an early search for allocating a suitable donor is indicated.
Collapse
Affiliation(s)
- Eolia Brissot
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du faubourg Saint-Antoine, 75571 Paris, Cedex 12 France
| | - Myriam Labopin
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du faubourg Saint-Antoine, 75571 Paris, Cedex 12 France
- Acute Leukemia Working Party Office, Hôpital Saint Antoine, APHP, Paris, France
| | - Matthias Stelljes
- Department of Medicine A/Hematology and Oncology, University of Muenster, Muenster, Germany
| | - Gerhard Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum, Dresden, Germany
| | | | - Jürgen Finke
- Faculty of Medicine and Medical Center, Hematology, Oncology and Stem Cell Transplantation, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | | | - Axel R. Zander
- Bone Marrow Transplantation Center, University Hospital Eppendorf, Hamburg, Germany
| | - Donald Bunjes
- Klinik fuer Innere Medizin III, Universtätklinikum, Ulm, Germany
| | - Stephan Mielke
- Department of Internal Medicine II, Würzburg University Medical Center, Würzburg, Germany
| | - Wolfgang A. Bethge
- Medical Department, Hematology and Oncology, University of Tuebingen, Tübingen, Germany
| | | | - Peter Kalhs
- Department of Internal Medicine I, Bone Marrow Transplantation Unit, Medical University of Vienna, Vienna, Austria
| | - Igor-Woflgang Blau
- Charite-Campus Benjamin Franklin Universitaetsmedizin Berlin Klinik III- Hematologie u Onkologie, Hindenburgdamm, Berlin, Germany
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Antonin Vitek
- Department of Clinical Hematology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - Ernst Holler
- Department of Haematology/Oncology, University Hospital Regensburg, Regensburg, Germany
| | | | - Jordi Esteve
- Hospital Clinic Institut d’investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Mohamad Mohty
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du faubourg Saint-Antoine, 75571 Paris, Cedex 12 France
- Acute Leukemia Working Party Office, Hôpital Saint Antoine, APHP, Paris, France
| | - Arnon Nagler
- Acute Leukemia Working Party Office, Hôpital Saint Antoine, APHP, Paris, France
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| |
Collapse
|
41
|
Schetelig J, de Wreede LC, Andersen NS, Moreno C, van Gelder M, Vitek A, Karas M, Michallet M, Machaczka M, Gramatzki M, Beelen D, Finke J, Delgado J, Volin L, Passweg J, Dreger P, Schaap N, Wagner E, Henseler A, van Biezen A, Bornhäuser M, Iacobelli S, Putter H, Schönland SO, Kröger N. Centre characteristics and procedure-related factors have an impact on outcomes of allogeneic transplantation for patients with CLL: a retrospective analysis from the European Society for Blood and Marrow Transplantation (EBMT). Br J Haematol 2017; 178:521-533. [DOI: 10.1111/bjh.14791] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/20/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Johannes Schetelig
- Medical Department I; University Hospital of the Technical University Dresden; Dresden Germany
- DKMS Clinical Trials Unit; Dresden Germany
| | - Liesbeth C. de Wreede
- DKMS Clinical Trials Unit; Dresden Germany
- Department of Medical Statistics & Bioinformatics; Leiden University Medical Centre; Leiden The Netherlands
| | - Niels S. Andersen
- BMT Unit Department of Haematology; Rigshospitalet; Copenhagen Denmark
| | - Carol Moreno
- Hematologia; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | | | - Antonin Vitek
- Department of Haematology; Institute of Haematology and Blood Transfusion; Prague Czech Republic
| | - Michal Karas
- Department of Haematology/Oncology; Charles University Hospital; Pilsen Czech Republic
| | | | - Maciej Machaczka
- Haematology Centre Karolinska and Department of Medicine at Huddinge; Karolinska Institutet; Stockholm Sweden
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy; University Hospital Schleswig-Holstein; Kiel Germany
| | - Dietrich Beelen
- Department of Bone Marrow Transplantation; University Hospital; Essen Germany
| | - Jürgen Finke
- Department of Medicine - Haematology, Oncology; University of Freiburg; Freiburg Germany
| | - Julio Delgado
- Institute of Haematology & Oncology; Department of Haematology; Hospital Clinic; Barcelona Spain
| | - Liisa Volin
- Stem Cell Transplantation Unit; Helsinki University Hospital Comprehensive Cancer Centre; Helsinki Finland
| | - Jakob Passweg
- Department for Haematology; University Hospital; Basel Switzerland
| | - Peter Dreger
- Medizinische Klinik u. Poliklinik V; University of Heidelberg; Heidelberg Germany
| | | | - Eva Wagner
- University Medical Centre Mainz; Mainz Germany
| | - Anja Henseler
- Department of Medical Statistics & Bioinformatics; Leiden University Medical Centre; Leiden The Netherlands
| | - Anja van Biezen
- Department of Medical Statistics & Bioinformatics; Leiden University Medical Centre; Leiden The Netherlands
| | - Martin Bornhäuser
- Medical Department I; University Hospital of the Technical University Dresden; Dresden Germany
| | | | - Hein Putter
- Department of Medical Statistics & Bioinformatics; Leiden University Medical Centre; Leiden The Netherlands
| | - Stefan O. Schönland
- Department of Haematology; Institute of Haematology and Blood Transfusion; Prague Czech Republic
| | - Nicolaus Kröger
- Bone Marrow Transplantation Centre; University Hospital Eppendorf; Hamburg Germany
| | | |
Collapse
|
42
|
Raab M, Chatterjee M, Goldschmidt H, Agis H, Blau IW, Einsele H, Engelhardt MM, Ferstl B, Gramatzki M, Röllig C, Weisel KC, Jarutat T, Weinelt D, Winderlich M, Boxhammer R, Peschel C. MOR202 with low-dose dexamethasone (Dex) and in combination with pomalidomide/dex and lenalidomide/dex in relapsed or refractory multiple myeloma (RRMM): Interim analysis of a phase I/IIa dose-escalation study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.8024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8024 Background: CD38 is a type II transmembrane glycoprotein expressed by MM cells. MOR202, a human IgG1 CD38 monoclonal antibody, has shown high single-agent activity in preclinical models of MM and synergy in combination with immunomodulatory drugs (IMiDs), lenalidomide (LEN) and pomalidomide (POM). Methods: This interim analysis of a multicenter phase I/IIa study reports safety and efficacy data from RRMM patient (pt) cohorts treated with clinically relevant doses of MOR202 (2-hour IV infusion; 4, 8 and 16 mg/kg q1w) + Dex (≤40 mg), or at 8 or 16 mg/kg q1w with an IMiD/Dex. Primary objectives were to evaluate the safety, maximum tolerated dose (MTD) and recommended phase II dose of MOR202. Results: As of January 2017, 79 pts had been treated, including 44 in clinically relevant cohorts: 18 received MOR202 + Dex, 15 MOR202 + LEN/Dex and 11 MOR202 + POM/Dex. Pts had received a median of 3, 2 and 3 prior treatment lines, respectively. The MTD of MOR202 was not reached. Combinations were generally well tolerated, with grade ≥3 adverse events (AEs) mainly hematological; 2 pts discontinued due to a MOR202-related AE (one grade 4 thrombocytopenia; one grade 3 acute kidney failure). Infusion-related reactions (all grade 1 or 2) were seen in only 3/44 (7%) pts, and mainly occurred during the first infusion. In the MOR202 + Dex cohort, 5/17 (29%) evaluable pts (receiving at least 1 cycle of treatment) had a response, including 3 with partial responses (PRs) and 2 with very good PRs (VGPRs). Responses were also seen in 11/13 (85%, 8 PRs, 3 VGPRs) evaluable pts in the MOR202 + LEN/Dex cohort and 5/9 (56%, 2 complete responses, 3 PRs) in the MOR202 + POM/Dex cohort. Longest response duration was 17 months (MOR202/Dex). Preliminary analysis showed preservation of high CD38 levels on MM cells under MOR202 therapy. Conclusions: In heavily pretreated pts with RRMM, a 2-hour infusion of MOR202 administered at up to 16 mg/kg with Dex or in combination with an IMiD/Dex, showed a favorable safety profile, including excellent infusion tolerability. Promising preliminary efficacy and long-lasting tumor control was seen. Clinical trial information: NCT01421186.
Collapse
Affiliation(s)
- Marc Raab
- Department of Medicine V, University Hospital Heidelberg and National Center for Tumor Diseases, Heidelberg, Germany
| | - Manik Chatterjee
- Department of Internal Medicine II, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Hartmut Goldschmidt
- Department of Medicine V, University Hospital Heidelberg and National Center for Tumor Diseases, Heidelberg, Germany
| | - Hermine Agis
- Department of Medicine I, University Hospital of Internal Medicine, AKH Wien, Vienna, Austria
| | - Igor W. Blau
- Department of Internal Medicine III, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital of Wuerzburg, Wuerzburg, Germany
| | | | - Barbara Ferstl
- Department of Internal Medicine 5 - Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Kiel, Germany
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | | | | | | | | | | | - Christian Peschel
- Department of Internal Medicine III, Technical University of Munich, Munich, Germany
| |
Collapse
|
43
|
Knop S, Langer C, Engelhardt MM, Wangemann J, Muegge LO, Bassermann F, Schaefer-Eckart K, Blau IW, Wolleschak D, Reichle A, Metzler IV, Metzner B, Röllig C, Hertenstein B, Pfreundschuh M, Brümmendorf TH, Gramatzki M, Ritgen M, Held S, Einsele H. Lenalidomide, doxorubicin hydrochloride and dexamethasone versus bortezomib, lenalidomide, and dexamethasone prior to scheduled stem cell transplant in newly diagnosed myeloma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.8001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8001 Background: In younger, medically fit patients (pts) with newly diagnosed (ND) multiple myeloma (MM), autologous stem cell transplant (SCT) remains a standard of care. Prior to SCT, induction triplets with at least one of the newer compounds are recommended. Bortezomib (V), lenalidomide (R) and dexamethasone (D; VRD) ranks amongst the most effective treatments. VRD + SCT proved superior over VRD alone in a randomized, controlled trial (RCT). We found encouraging efficacy and low toxicity with RAD (RD and adriamycin) + SCT and decided to compare RAD versus VRD induction in an RCT. Methods: The DSMM XIV study was set up according to a double 2x2-factorial design to enroll NDMM pts up to 65 years (yrs). Post-induction (PI) CR rate was the efficacy endpoint for the initial study phase. We hypothesized CR rate with RAD would be non-inferior to an estimated 20% CR with VRD. The study was powered to confirm non-inferiority of RAD at a 10% margin with a one-sided α level of .05. Minimal residual disease (MRD) was analyzed by eight-color flow cytometry (EuroFlow standards) on marrow samples. Results: 476 pts were randomized between 05/2012 and 06/2016, 469 of whom (median age 55 (range, 32–65) yrs) received at least one dose of study drug. 18.3% of pts had ISS stage III MM and 17.2%, elevated LDH. 11.3% of pts had del17p; 11.1% had t(4;14); and 4% had t(14;16). 232 pts were randomized to 3 four-week RAD cycles and 237 to 3 three-week VRD cycles, respectively. 89.7% of RAD versus 93.2% of VRD pts completed all induction cycles. PI CR rate was 11.8% (90% CI, 7.9%-16.3%) with RAD versus 13.0% (90% CI, 8.9-18.0) with VRD, (P = .697). 72/317 pts (22.7%) with paired baseline/PI samples achieved negative MRD at a median sensitivity level of 6.73x10-6. 47 (20.3%) RAD versus 35 (14.8%) VRD pts experienced treatment-emergent SAEs (P = .144). Treatment-related induction mortality was 0% in either arm. Conclusions: To the best of our knowledge, this is the first RCT to compare two lenalidomide-based triplets prior to SCT. The endpoint was met with comparable PI CR rates for RAD and VRD, respectively. Tolerability was encouraging in both arms. Follow-up data is needed to analyze time-dependent endpoints. Clinical trial information: NCT01685814.
Collapse
Affiliation(s)
- Stefan Knop
- Medizinische Klinik und Poliklinik II, Julius Maximilians Universität Würzburg, Würzburg, Germany
| | - Christian Langer
- Universitätsklinikum Ulm Klinik für Innere Medizin III, Ulm, Germany
| | | | | | | | - Florian Bassermann
- Department of Medicine III, Technische Universität München, München, Germany
| | | | - Igor W. Blau
- Department of Internal Medicine III, Charité Campus Benjamin Franklin, Berlin, Germany
| | | | | | | | - Bernd Metzner
- Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Bernd Hertenstein
- Department of Hematology and Oncology, Klinikum Bremen Mitte, Bremen, Germany
| | | | | | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Kiel, Germany
| | - Matthias Ritgen
- Medical Department II, University of Schleswig Holstein, City Hospital Kiel, Kiel, Germany
| | | | - Hermann Einsele
- Department of Internal Medicine II, University Hospital of Wuerzburg, Wuerzburg, Germany
| | | |
Collapse
|
44
|
Schetelig J, de Wreede LC, van Gelder M, Andersen NS, Moreno C, Vitek A, Karas M, Michallet M, Machaczka M, Gramatzki M, Beelen D, Finke J, Delgado J, Volin L, Passweg J, Dreger P, Henseler A, van Biezen A, Bornhäuser M, Schönland SO, Kröger N. Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2017; 52:552-560. [PMID: 28112746 DOI: 10.1038/bmt.2016.329] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/23/2016] [Accepted: 08/31/2016] [Indexed: 11/09/2022]
Abstract
For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n= 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good- and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT.
Collapse
Affiliation(s)
- J Schetelig
- Medical Department I, University Hospital, Technische Universität Dresden, Dresden, Germany.,Clinical Trials Unit, DKMS, gemeinnützige GmbH, Tübingen, Germany
| | - L C de Wreede
- Clinical Trials Unit, DKMS, gemeinnützige GmbH, Tübingen, Germany.,Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - M van Gelder
- Department of Internal Medicine, Division of Hematology, University Medical Center Maastricht, The Netherlands
| | - N S Andersen
- BMT Unit, Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - C Moreno
- Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Vitek
- Department of Hematology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - M Karas
- Department of Hematology/Oncology, Charles University Hospital, Pilsen, Czech Republic
| | - M Michallet
- Hématologie, Center Hospitalier Lyon-Sud, Lyon, France
| | - M Machaczka
- Department of Medicine at Huddinge, Hematology Center Karolinska and Karolinska Institutet, Stockholm, Sweden
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - D Beelen
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - J Finke
- Department of Medicine-Hematology, University of Freiburg, Oncology, Freiburg, Germany
| | - J Delgado
- Department of Hematology, Hospital Clinic, Institute of Hematology & Oncology, Barcelona, Spain
| | - L Volin
- Stem Cell Transplantation Unit, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | - J Passweg
- Department for Hematology, University Hospital, Basel, Switzerland
| | - P Dreger
- Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - A Henseler
- Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - A van Biezen
- Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Bornhäuser
- Medical Department I, University Hospital, Technische Universität Dresden, Dresden, Germany
| | - S O Schönland
- Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - N Kröger
- Bone Marrow Transplantation Center, University Hospital Eppendorf, Hamburg, Germany
| |
Collapse
|
45
|
Fürst D, Niederwieser D, Bunjes D, Wagner EM, Gramatzki M, Wulf G, Müller CR, Neuchel C, Tsamadou C, Schrezenmeier H, Mytilineos J. Increased age-associated mortality risk in HLA-mismatched hematopoietic stem cell transplantation. Haematologica 2017; 102:796-803. [PMID: 28057735 PMCID: PMC5395120 DOI: 10.3324/haematol.2016.151340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/28/2016] [Indexed: 02/06/2023] Open
Abstract
We investigated a possible interaction between age-associated risk and HLA-mismatch associated risk on prognosis in different age categories of recipients of unrelated hematopoietic stem cell transplants (HSCT) (n=3019). Patients over 55 years of age transplanted with 8/10 donors showed a mortality risk of 2.27 (CI 1.70–3.03, P<0.001) and 3.48 (CI 2.49–4.86, P<0.001) when compared to 10/10 matched patients in the same age group and to 10/10 matched patients aged 18–35 years, respectively. Compared to 10/10 matched transplantations within each age category, the Hazards Ratio for 8/10 matched transplantation was 1.14, 1.40 and 2.27 in patients aged 18–35 years, 36–55 and above 55 years. Modeling age as continuous variable showed different levels of risk attributed to age at the time of transplantation [OS: 10/10: Hazards Ratio 1.015 (per life year); 9/10: Hazards Ratio: 1.019; 8/10: Hazards Ratio 1.026]. The interaction term was significant for 8/10 transplantations (P=0.009). Findings for disease-free survival and transplant-related mortality were similar. Statistical models were stratified for diagnosis and included clinically relevant predictors except cytomegalovirus status and Karnofsky performance status. The risk conferred by age at the time of transplantation varies according to the number of HLA-mismatches and leads to a disproportional increase in risk for elderly patients, particularly with double mismatched donors. Our findings highlight the importance of HLA-matching, especially in patients over 55 years of age, as HLA-mismatches are less well tolerated in these patients. The interaction between age-associated risk and HLA-mismatches should be considered in donor selection and in the risk assessment of elderly HSCT recipients.
Collapse
Affiliation(s)
- Daniel Fürst
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Germany
| | | | - Donald Bunjes
- Department of Internal Medicine III, University of Ulm, Germany
| | - Eva M Wagner
- Department of Medicine III, Johannes Gutenberg-University Mainz, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University of Kiel, Germany
| | - Gerald Wulf
- Department of Hematology/Oncology, Georg-August-University Göttingen, Germany
| | - Carlheinz R Müller
- ZKRD-Zentrales Knochenmarkspender-Register für Deutschland (German National Bone Marrow Donor Registry), Ulm, Germany.,DRST - German Registry for Stem Cell Transplantation, Ulm, Germany
| | - Christine Neuchel
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Germany
| | - Chrysanthi Tsamadou
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Germany
| | - Joannis Mytilineos
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg - Hessen, Ulm, Germany .,Institute of Transfusion Medicine, University of Ulm, Germany.,DRST - German Registry for Stem Cell Transplantation, Ulm, Germany
| |
Collapse
|
46
|
Burger R, Günther A, Klausz K, Staudinger M, Peipp M, Penas EMM, Rose-John S, Wijdenes J, Gramatzki M. Due to interleukin-6 type cytokine redundancy only glycoprotein 130 receptor blockade efficiently inhibits myeloma growth. Haematologica 2016; 102:381-390. [PMID: 27658435 DOI: 10.3324/haematol.2016.145060] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 09/14/2016] [Indexed: 12/25/2022] Open
Abstract
Interleukin-6 has an important role in the pathophysiology of multiple myeloma where it supports the growth and survival of the malignant plasma cells in the bone marrow. It belongs to a family of cytokines which use the glycoprotein 130 chain for signal transduction, such as oncostatin M or leukemia inhibitory factor. Targeting interleukin-6 in plasma cell diseases is currently evaluated in clinical trials with monoclonal antibodies. Here, efforts were made to elucidate the contribution of interleukin-6 and glycoprotein 130 signaling in malignant plasma cell growth in vivo In the xenograft severe combined immune deficiency model employing our interleukin-6-dependent plasma cell line INA-6, the lack of human interleukin-6 induced autocrine interleukin-6 production and a proliferative response to other cytokines of the glycoprotein 130 family. Herein, mice were treated with monoclonal antibodies against human interleukin-6 (elsilimomab/B-E8), the interleukin-6 receptor (B-R6), and with an antibody blocking glycoprotein 130 (B-R3). While treatment of mice with interleukin-6 and interleukin-6 receptor antibodies resulted in a modest delay in tumor growth, the development of plasmacytomas was completely prevented with the anti-glycoprotein 130 antibody. Importantly, complete inhibition was also achieved using F(ab')2-fragments of monoclonal antibody B-R3. Tumors harbor activated signal transducer and activator of transcription 3, and in vitro, the antibody inhibited leukemia inhibitory factor stimulated signal transducer and activator of transcription 3 phosphorylation and cell growth, while being less effective against interleukin-6. In conclusion, the growth of INA-6 plasmacytomas in vivo under interleukin-6 withdrawal remains strictly dependent on glycoprotein 130, and other glycoprotein 130 cytokines may substitute for interleukin-6. Antibodies against glycoprotein 130 are able to overcome this redundancy and should be explored for a possible therapeutic window.
Collapse
Affiliation(s)
- Renate Burger
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Andreas Günther
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Katja Klausz
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Matthias Staudinger
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Eva Maria Murga Penas
- Institute of Human Genetics, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Stefan Rose-John
- Department of Biochemistry, Christian-Albrechts-University of Kiel, Medical Faculty, Germany
| | | | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, Department of Internal Medicine II, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
47
|
Tsamadou C, Fürst D, Niederwieser D, Bunjes D, Neuchel C, Gramatzki M, Arnold R, Wagner E, Einsele H, Schrezenmeier H, Mytilineos J. P046 Deconstructing HLA-C mismatch in hematopoietic stem cell transplantation. Hum Immunol 2016. [DOI: 10.1016/j.humimm.2016.07.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
48
|
Peipp M, Derer S, Lohse S, Staudinger M, Klausz K, Valerius T, Gramatzki M, Kellner C. HER2-specific immunoligands engaging NKp30 or NKp80 trigger NK-cell-mediated lysis of tumor cells and enhance antibody-dependent cell-mediated cytotoxicity. Oncotarget 2016; 6:32075-88. [PMID: 26392331 PMCID: PMC4741660 DOI: 10.18632/oncotarget.5135] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 09/04/2015] [Indexed: 12/19/2022] Open
Abstract
NK cells detect tumors through activating surface receptors, which bind self-antigens that are frequently expressed upon malignant transformation. To increase the recognition of tumor cells, the extracellular domains of ligands of the activating NK cell receptors NKp30, NKp80 and DNAM-1 (i.e. B7-H6, AICL and PVR, respectively) were fused to a single-chain fragment variable (scFv) targeting the human epidermal growth factor receptor 2 (HER2), which is displayed by various solid tumors. The resulting immunoligands, designated B7-H6:HER2-scFv, AICL:HER2-scFv, and PVR:HER2-scFv, respectively, bound HER2 and the addressed NK cell receptor. However, whereas B7-H6:HER2-scFv and AICL:HER2-scFv triggered NK cells to kill HER2-positive breast cancer cells at nanomolar concentrations, PVR:HER2-scFv was not efficacious. Moreover, NK cell cytotoxicity was enhanced synergistically when B7-H6:HER2-scFv or AICL:HER2-scFv were applied in combination with another HER2-specific immunoligand engaging the stimulatory receptor NKG2D. In contrast, no improvements were achieved by combining B7-H6:HER2-scFv with AICL:HER2-scFv. Additionally, B7-H6:HER2-scFv and AICL:HER2-scFv enhanced antibody-dependent cell-mediated cytotoxicity (ADCC) by the therapeutic antibodies trastuzumab and cetuximab synergistically, with B7-H6:HER2-scFv exhibiting a higher efficacy. In summary, antibody-derived proteins engaging NKp30 or NKp80 may represent attractive biologics to further enhance anti-tumor NK cell responses and may provide an innovative approach to sensitize tumor cells for antibody-based immunotherapy.
Collapse
Affiliation(s)
- Matthias Peipp
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Stefanie Derer
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Stefan Lohse
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Matthias Staudinger
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Katja Klausz
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Thomas Valerius
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christian Kellner
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| |
Collapse
|
49
|
Straka C, Liebisch P, Salwender H, Hennemann B, Metzner B, Knop S, Adler-Reichel S, Gerecke C, Wandt H, Bentz M, Bruemmendorf TH, Hentrich M, Pfreundschuh M, Wolf HH, Sezer O, Bargou R, Jung W, Trümper L, Hertenstein B, Heidemann E, Bernhard H, Lang N, Frickhofen N, Hebart H, Schmidmaier R, Sandermann A, Dechow T, Reichle A, Schnabel B, Schäfer-Eckart K, Langer C, Gramatzki M, Hinke A, Emmerich B, Einsele H. Autotransplant with and without induction chemotherapy in older multiple myeloma patients: long-term outcome of a randomized trial. Haematologica 2016; 101:1398-1406. [PMID: 27662018 DOI: 10.3324/haematol.2016.151860] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/03/2016] [Indexed: 12/22/2022] Open
Abstract
Autologous transplantation is controversial for older patients with multiple myeloma. The role of age-adjusted high-dose melphalan and the impact of induction chemotherapy cycles is still unclear. A total of 434 patients aged 60-70 years were randomly assigned to 4 cycles of standard anthracycline-based induction chemotherapy or no induction. For all patients, double autologous transplantation after melphalan 140 mg/m2 (MEL140) was planned. The primary end point was progression-free survival. Of 420 eligible patients, 85% received a first transplant and 69% completed double transplantation. Treatment duration was short with a median of 7.7 months with induction chemotherapy cycles and 4.6 months without induction. On an intention-to-treat basis, median progression-free survival with induction chemotherapy cycles (207 patients) was 21.4 months versus 20.0 months with no induction cycles (213 patients) (hazard ratio 1.04, 95% confidence interval 0.84-1.28; P=0.36). Per protocol, progression-free survival was 23.7 months versus 23.0 months (P=0.28). Patients aged 65 years or over (55%) did not have an inferior outcome. Patients with low-risk cytogenetics [absence of del17p13, t(4;14) and 1q21 gains] showed a favorable overall survival and included the patients with sustained first remission. MEL140 was associated with a low rate of severe mucositis (10%) and treatment-related deaths (1%). Based on hazard ratio, the short treatment arm consisting of mobilization chemotherapy and tandem MEL140 achieved 96% of the progression-free survival, demonstrating its value as an independent component of therapy in older patients with multiple myeloma who are considered fit for autologous transplantation. (clinicaltrials.gov identifier: 02288741).
Collapse
Affiliation(s)
- Christian Straka
- Schön Klinik Starnberger See, Berg, Germany .,Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Germany
| | | | | | | | | | - Stefan Knop
- Universitätsklinikum Tübingen, Germany.,Universitätsklinikum Würzburg, Germany
| | - Sigrid Adler-Reichel
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Germany
| | | | | | | | | | | | | | | | - Orhan Sezer
- Universitätsklinikum Charité, Berlin, Germany
| | - Ralf Bargou
- Universitätsklinikum Würzburg, Germany.,Universitätsklinikum Charité, Berlin, Germany
| | | | | | | | | | - Helga Bernhard
- Klinikum rechts der Isar, Technische Universität München, Germany
| | - Nicola Lang
- Medizinische Klinik und Poliklinik III, Klinikum der Universität München (LMU), Germany
| | | | - Holger Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | - Ralf Schmidmaier
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Germany
| | | | - Tobias Dechow
- Klinikum rechts der Isar, Technische Universität München, Germany
| | | | - Brigitte Schnabel
- Schön Klinik Starnberger See, Berg, Germany.,Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Germany
| | | | | | | | - Axel Hinke
- WISP Research Institute, Langenfeld, Germany
| | - Bertold Emmerich
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Germany
| | - Hermann Einsele
- Universitätsklinikum Tübingen, Germany.,Universitätsklinikum Würzburg, Germany
| |
Collapse
|
50
|
Raab MS, Chatterjee M, Goldschmidt H, Agis H, Blau IW, Einsele H, Engelhardt MM, Ferstl B, Gramatzki M, Röllig C, Weisel K, Kloepfer P, Weinelt D, Endell J, Boxhammer R, Peschel C. MOR202 alone and in combination with pomalidomide or lenalidomide in relapsed or refractory multiple myeloma: Data from clinically relevant cohorts from a phase I/IIa study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.8012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Marc S. Raab
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Manik Chatterjee
- Department of Internal Medicine II, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Hartmut Goldschmidt
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Hermine Agis
- Department of Medicine I, University Hospital of Internal Medicine – AKH Wien, Vienna, Austria
| | - Igor W Blau
- Department of Internal Medicine III, Charité Campus Benjamin Franklin, Berlin, Germany
| | | | | | - Barbara Ferstl
- Department of Internal Medicine 5 - Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nuernberg, Erlangen, Germany
| | - Martin Gramatzki
- Department of Medicine, University Hospital Schleswig-Holstein Division of Stem Cell Transplantation and Immunotherapy, Kiel, Germany
| | | | - Katja Weisel
- Department of Hematology, Oncology, Immunology, Rheumatology and Pulmonology, University Hospital of Tuebingen, Tuebingen, Germany
| | | | | | | | | | - Christian Peschel
- Department of Internal Medicine III, Technical University of Munich, Munich, Germany
| |
Collapse
|