Sangiolo D, Mesiano G, Carnevale-Schianca F, Piacibello W, Aglietta M, Cignetti A
Institute for Cancer Research and Treatment (IRCC), Laboratory of Medical Oncology, Strada Provinciale 142, Candiolo (TO), Italy.
Expert Opin Biol Ther. 2009 Jul;9(7):831-40. doi: 10.1517/14712590903005552.
Donor lymphocyte infusion (DLI) is used to increase the graft versus tumor (GVT) effect after allogeneic hematopoietic cell transplant (HCT). The limited spectrum of activity and high risk of graft versus host disease (GVHD) remain major limitations of this approach. The finding of new cell populations for adoptive immunotherapy, with the ability to separate GVT from GVHD, would be useful. Here we review the main basic, preclinical and clinical research on cytokine-induced killer (CIK) cells, highlighting the aspects of their antitumor and alloreactive potentials that might favourably affect the balance between GVT and GVHD. CIK cells are ex vivo-expanded T lymphocytes sharing NK markers and endowed with a potent MHC-unrestricted antitumor activity against haematological and solid malignancies. Studies in preclinical animal models have demonstrated their low GVHD potential when infused across MHC-barriers, and recent clinical studies seem to confirm these findings in patients with hematological malignancies relapsing after HCT. If consolidated with larger clinical trials, adoptive immunotherapy with CIK cells might represent an effective alternative to classic DLI, helping HCT to succesfully meet current challenges like the extension across major HLA-barriers and application to solid tumors.
供体淋巴细胞输注(DLI)用于增强异基因造血细胞移植(HCT)后的移植物抗肿瘤(GVT)效应。这种方法的活性谱有限以及移植物抗宿主病(GVHD)风险高仍然是主要局限性。找到用于过继性免疫治疗的新细胞群体,使其能够区分GVT和GVHD,将是很有用的。在此,我们综述了关于细胞因子诱导的杀伤(CIK)细胞的主要基础、临床前和临床研究,重点介绍了其抗肿瘤和同种异体反应潜力中可能有利于影响GVT和GVHD之间平衡的方面。CIK细胞是体外扩增的T淋巴细胞,具有NK细胞标志物,并对血液系统恶性肿瘤和实体恶性肿瘤具有强大的MHC非限制性抗肿瘤活性。临床前动物模型研究表明,当跨越MHC屏障输注时,它们的GVHD潜力较低,最近的临床研究似乎也在HCT后复发的血液系统恶性肿瘤患者中证实了这些发现。如果通过更大规模的临床试验得到巩固,CIK细胞过继性免疫治疗可能成为经典DLI的有效替代方法,帮助HCT成功应对当前的挑战,如跨越主要HLA屏障以及应用于实体瘤。
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