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从脐血和外周血中通过单一培养获得具有抗病毒和抗白血病特异性的人 T 淋巴细胞,以防止干细胞移植后感染和复发。

Derivation of human T lymphocytes from cord blood and peripheral blood with antiviral and antileukemic specificity from a single culture as protection against infection and relapse after stem cell transplantation.

机构信息

Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

出版信息

Blood. 2010 Apr 1;115(13):2695-703. doi: 10.1182/blood-2009-09-242263. Epub 2010 Jan 28.


DOI:10.1182/blood-2009-09-242263
PMID:20110422
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2852368/
Abstract

Viral infections and leukemic relapse account for the majority of treatment failures in patients with B-cell acute lymphoblastic leukemia (B-ALL) receiving allogeneic hematopoietic stem cell (HSC) or cord blood (CB) transplants. Adoptive transfer of virus-specific cytotoxic T lymphocytes (CTLs) provides protection against common viruses causing serious infections after HSC transplantation without concomitant graft-versus-host disease. We have now generated CTL lines from peripheral blood (PB) or CB units that recognize multiple common viruses and provide antileukemic activity by transgenic expression of a chimeric antigen receptor (CAR) targeting CD19 expressed on B-ALL. PB-derived CAR(+) CTLs produced interferon-gamma (IFNgamma) in response to cytomegalovirus-pp65, adenovirus-hexon, and Epstein-Barr virus pepmixes (from 205 +/- 104 to 1034 +/- 304 spot-forming cells [SFCs]/10(5) T cells) and lysed primary B-ALL blasts in (51)Cr-release assays (mean, 66% +/- 5% specific lysis; effector-target [E/T] ratio, 40:1) and the CD19(+) Raji cell line (mean, 78% +/- 17%) in contrast to nontransduced controls (8% +/- 8% and 3% +/- 2%). CB-derived CAR(+) CTLs showed similar antiviral and antitumor function and both PB and CB CAR(+) CTLs completely eliminated B-ALL blasts over 5 days of coculture. This approach may prove beneficial for patients with high-risk B-ALL who have recently received an HSC or CB transplant and are at risk of infection and relapse.

摘要

病毒感染和白血病复发是接受异基因造血干细胞(HSC)或脐带血(CB)移植的 B 细胞急性淋巴细胞白血病(B-ALL)患者治疗失败的主要原因。过继转移病毒特异性细胞毒性 T 淋巴细胞(CTL)可预防 HSC 移植后导致严重感染的常见病毒,而不会同时发生移植物抗宿主病。我们现在已经从外周血(PB)或 CB 单位中生成了识别多种常见病毒的 CTL 系,并通过靶向 B-ALL 上表达的 CD19 的嵌合抗原受体(CAR)的转基因表达提供抗白血病活性。PB 衍生的 CAR(+)CTL 对巨细胞病毒-pp65、腺病毒-hexon 和 Epstein-Barr 病毒 pepmix 产生干扰素-γ(IFNgamma)(从 205 +/- 104 到 1034 +/- 304 斑点形成细胞 [SFC]/10(5)T 细胞),并在 51Cr 释放测定中裂解原代 B-ALL blasts(平均,66% +/- 5%特异性裂解;效应物-靶标 [E/T] 比,40:1)和 CD19(+) Raji 细胞系(平均,78% +/- 17%),而与未转导的对照(8% +/- 8%和 3% +/- 2%)相比。CB 衍生的 CAR(+)CTL 表现出类似的抗病毒和抗肿瘤功能,PB 和 CB CAR(+)CTL 在 5 天共培养中完全消除了 B-ALL blasts。这种方法可能对最近接受 HSC 或 CB 移植且有感染和复发风险的高危 B-ALL 患者有益。

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[6]
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[7]
Viral Infections in HSCT: Detection, Monitoring, Clinical Management, and Immunologic Implications.

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[8]
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[9]
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本文引用的文献

[1]
Fifteen years of gene therapy based on chimeric antigen receptors: "are we nearly there yet?".

Hum Gene Ther. 2009-11

[2]
Cytotoxic T lymphocyte therapy with donor T cells prevents and treats adenovirus and Epstein-Barr virus infections after haploidentical and matched unrelated stem cell transplantation.

Blood. 2009-11-5

[3]
Mechanisms and functions for the duration of intercellular contacts made by lymphocytes.

Nat Rev Immunol. 2009-8

[4]
Immunotherapy of lymphoma and leukemia with T-cell engaging BiTE antibody blinatumomab.

Leuk Lymphoma. 2009-6

[5]
Functionally active virus-specific T cells that target CMV, adenovirus, and EBV can be expanded from naive T-cell populations in cord blood and will target a range of viral epitopes.

Blood. 2009-8-27

[6]
How we treat cytomegalovirus in hematopoietic cell transplant recipients.

Blood. 2009-6-4

[7]
Umbilical cord blood transplantation: pros, cons and beyond.

Blood Rev. 2009-9

[8]
Optimizing unrelated donor cord blood transplantation.

Biol Blood Marrow Transplant. 2009-1

[9]
Virus-specific T cells engineered to coexpress tumor-specific receptors: persistence and antitumor activity in individuals with neuroblastoma.

Nat Med. 2008-11

[10]
Expansion of antileukaemia CTL lines and clones for adoptive cell therapy in paediatric patients given allogeneic haematopoietic stem cell transplantation.

Int J Immunogenet. 2008-8

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