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有效的免疫疗法在慢性髓性白血病(CML)中识别出在 CML 祖细胞上表达的抗原。

Efficacious immune therapy in chronic myelogenous leukemia (CML) recognizes antigens that are expressed on CML progenitor cells.

机构信息

Cancer Vaccine Center and Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Cancer Res. 2010 Feb 1;70(3):906-15. doi: 10.1158/0008-5472.CAN-09-2303. Epub 2010 Jan 26.

Abstract

Curative effects of graft-versus-leukemia-based therapies such as donor lymphocyte infusion (DLI) for chronic myelogenous leukemia (CML) may result from immunologic ablation of self-renewing CML progenitor cells. Patients who achieved durable remissions after DLI developed a significant B-cell lymphocytosis after treatment, which did not occur in patients who were unresponsive to DLI. In this study, we identified antigen targets of this B-cell response by probing two immunoproteomic platforms with plasma immunoglobulins from seven CML patients with clinically apparent graft-versus-leukemia responses after DLI. In total, 62 antigens elicited greater reactivity from post-DLI versus pre-DLI plasma. Microarray analysis revealed that >70% of the antigens were expressed in CML CD34(+) cells, suggesting that expression in malignant progenitor cells is a feature common to antibody targets of DLI. We confirmed elevated expression of three target antigens (RAB38, TBCE, and DUSP12) in CML that together consistently elicited antibody responses in 18 of 21 of an additional cohort of CML patients with therapeutic responses, but not in normal donors and rarely in non-CML patients. In summary, immunologic targets of curative DLI responses include multiple antigens on CML progenitor cells, identifying them as potential immunogens for vaccination and/or monitoring of immunotherapeutics designed to eliminate myeloid leukemia stem cells.

摘要

基于移植物抗白血病的治疗方法(如供者淋巴细胞输注 [DLI])对慢性髓系白血病(CML)的疗效可能源于对自我更新的 CML 祖细胞的免疫消融。在 DLI 后获得持久缓解的患者在治疗后会出现明显的 B 细胞淋巴细胞增多症,但对 DLI 无反应的患者则不会出现这种情况。在这项研究中,我们通过用来自 7 名 CML 患者的血浆免疫球蛋白探测两种免疫蛋白质组学平台,鉴定了这种 B 细胞反应的抗原靶标。这些患者在 DLI 后出现明显的移植物抗白血病反应。总共,62 种抗原在 DLI 后与 DLI 前血浆相比具有更高的反应性。微阵列分析显示,>70%的抗原在 CML CD34+细胞中表达,这表明恶性祖细胞中的表达是 DLI 抗体靶标的共同特征。我们证实了三个靶抗原(RAB38、TBCE 和 DUSP12)在 CML 中的表达升高,它们在另外 21 名具有治疗反应的 CML 患者的 18 名患者中一致地引起了抗体反应,但在正常供体中很少见,在非 CML 患者中也很少见。总之,有疗效的 DLI 反应的免疫靶标包括 CML 祖细胞上的多个抗原,将它们鉴定为疫苗接种和/或监测设计用于消除髓样白血病干细胞的免疫治疗的潜在免疫原。

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