van Loenen Marleen M, de Boer Renate, van Liempt Ellis, Meij Pauline, Jedema Inge, Falkenburg J H Frederik, Heemskerk Mirjam H M
Haematologica. 2014 Apr;99(4):759-68. doi: 10.3324/haematol.2013.093690. Epub 2013 Dec 13.
A sequential, two-step procedure in which T-cell-depleted allogeneic stem cell transplantation is followed by treatment with donor lymphocyte infusion at 6 months can significantly reduce the risk and severity of graft-versus-host disease, with postponed induction of the beneficial graft-versus-leukemia effect. However, patients with high-risk leukemia have a substantial risk of relapse early after transplantation, at a time when administration of donor lymphocytes has a high likelihood of resulting in graft-versus-host disease, disturbing a favorable balance between the graft-versus-leukemia effect and graft-versus-host disease. New therapeutic modalities are, therefore, required to allow early administration of T cells capable of exerting a graft-versus-leukemia effect without causing graft-versus-host disease. Here we describe the isolation of virus-specific T cells using Streptamer-based isolation technology and subsequent transfer of the minor histocompatibility antigen HA-1-specific T-cell receptor using retroviral vectors. Isolation of virus-specific T cells and subsequent transduction with HA-1-T-cell receptor resulted in rapid in vitro generation of highly pure, dual-specific T cells with potent anti-leukemic reactivity. Due to the short production procedure of only 10-14 days and the defined specificity of the T cells, administration of virus-specific T cells transduced with the HA-1-T-cell receptor as early as 8 weeks after allogeneic stem cell transplantation is feasible. (This clinical trial is registered at www.clinicaltrialsregister.eu as EudraCT number 2010-024625-20).
一种序贯的两步程序,即先进行去除T细胞的异基因干细胞移植,6个月后再用供体淋巴细胞输注进行治疗,可显著降低移植物抗宿主病的风险和严重程度,同时推迟有益的移植物抗白血病效应的诱导。然而,高危白血病患者在移植后早期有很高的复发风险,此时给予供体淋巴细胞很可能导致移植物抗宿主病,破坏移植物抗白血病效应和移植物抗宿主病之间的有利平衡。因此,需要新的治疗方式,以便能够早期给予具有移植物抗白血病效应而不引起移植物抗宿主病的T细胞。在此,我们描述了使用基于链霉亲和素的分离技术分离病毒特异性T细胞,并随后使用逆转录病毒载体转移次要组织相容性抗原HA-1特异性T细胞受体。分离病毒特异性T细胞并随后用HA-1-T细胞受体进行转导,可在体外快速产生具有高效抗白血病反应性的高度纯化的双特异性T细胞。由于生产过程仅需10 - 14天且T细胞特异性明确,在异基因干细胞移植后8周尽早给予用HA-1-T细胞受体转导的病毒特异性T细胞是可行的。(该临床试验已在www.clinicaltrialsregister.eu注册,欧洲药品管理局临床试验编号为2010 - 024625 - 20)
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