Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Blood. 2010 Apr 1;115(13):2695-703. doi: 10.1182/blood-2009-09-242263. Epub 2010 Jan 28.
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.
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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