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Donor CD19 CAR T cells exert potent graft-versus-lymphoma activity with diminished graft-versus-host activity.

作者信息

Ghosh Arnab, Smith Melody, James Scott E, Davila Marco L, Velardi Enrico, Argyropoulos Kimon V, Gunset Gertrude, Perna Fabiana, Kreines Fabiana M, Levy Emily R, Lieberman Sophie, Jay Hillary V, Tuckett Andrea Z, Zakrzewski Johannes L, Tan Lisa, Young Lauren F, Takvorian Kate, Dudakov Jarrod A, Jenq Robert R, Hanash Alan M, Motta Ana Carolina F, Murphy George F, Liu Chen, Schietinger Andrea, Sadelain Michel, van den Brink Marcel R M

机构信息

Department of Medicine and Immunology Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Center of Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

出版信息

Nat Med. 2017 Feb;23(2):242-249. doi: 10.1038/nm.4258. Epub 2017 Jan 9.


DOI:10.1038/nm.4258
PMID:28067900
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5528161/
Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative therapy for hematological malignancies. However, graft-versus-host disease (GVHD) and relapse after allo-HSCT remain major impediments to the success of allo-HSCT. Chimeric antigen receptors (CARs) direct tumor cell recognition of adoptively transferred T cells. CD19 is an attractive CAR target, which is expressed in most B cell malignancies, as well as in healthy B cells. Clinical trials using autologous CD19-targeted T cells have shown remarkable promise in various B cell malignancies. However, the use of allogeneic CAR T cells poses a concern in that it may increase risk of the occurrence of GVHD, although this has not been reported in selected patients infused with donor-derived CD19 CAR T cells after allo-HSCT. To understand the mechanism whereby allogeneic CD19 CAR T cells may mediate anti-lymphoma activity without causing a significant increase in the incidence of GVHD, we studied donor-derived CD19 CAR T cells in allo-HSCT and lymphoma models in mice. We demonstrate that alloreactive T cells expressing CD28-costimulated CD19 CARs experience enhanced stimulation, resulting in the progressive loss of both their effector function and proliferative potential, clonal deletion, and significantly decreased occurrence of GVHD. Concurrently, the other CAR T cells that were present in bulk donor T cell populations retained their anti-lymphoma activity in accordance with the requirement that both the T cell receptor (TCR) and CAR be engaged to accelerate T cell exhaustion. In contrast, first-generation and 4-1BB-costimulated CAR T cells increased the occurrence of GVHD. These findings could explain the reduced risk of GVHD occurring with cumulative TCR and CAR signaling.

摘要

相似文献

[1]
Donor CD19 CAR T cells exert potent graft-versus-lymphoma activity with diminished graft-versus-host activity.

Nat Med. 2017-2

[2]
[Maintenance therapy following CD19 CAR-T treatment for relapsed B-cell acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation].

Zhonghua Xue Ye Xue Za Zhi. 2020-6-14

[3]
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[4]
[Allogeneic donor-derived CD19 CAR-T therapy of relapsed B-cell acute lmphoblastic leukemia after allogeneic hematopoietic stem cell transplantation].

Zhonghua Xue Ye Xue Za Zhi. 2021-5-14

[5]
Allogeneic T Cells That Express an Anti-CD19 Chimeric Antigen Receptor Induce Remissions of B-Cell Malignancies That Progress After Allogeneic Hematopoietic Stem-Cell Transplantation Without Causing Graft-Versus-Host Disease.

J Clin Oncol. 2016-4-1

[6]
Donor origin CAR T cells: graft versus malignancy effect without GVHD, a systematic review.

Immunotherapy. 2017-1

[7]
Combining CD19 redirection and alloanergization to generate tumor-specific human T cells for allogeneic cell therapy of B-cell malignancies.

Cancer Res. 2010-4-27

[8]
Efficacy and safety of CD19 CAR-T cell therapy for acute lymphoblastic leukemia patients relapsed after allogeneic hematopoietic stem cell transplantation.

Int J Hematol. 2022-9

[9]
Murine allogeneic CD19 CAR T cells harbor potent antileukemic activity but have the potential to mediate lethal GVHD.

Blood. 2016-3-10

[10]
Infusion of donor-derived CD19-redirected virus-specific T cells for B-cell malignancies relapsed after allogeneic stem cell transplant: a phase 1 study.

Blood. 2013-9-12

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[2]
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[3]
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[4]
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[5]
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Bone Marrow Transplant. 2025-4-9

[6]
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Blood Cancer J. 2025-4-3

[7]
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Mol Ther. 2025-4-2

[8]
Targeting BCL11B in CAR-engineered lymphoid progenitors drives NK-like cell development with prolonged anti-leukemic activity.

Mol Ther. 2025-4-2

[9]
Clinicopathologic Effects of Xenogeneic GvHD Induced by Adoptively Transferred Human-Derived T Cells in Severely Immunodeficient Mice.

Arch Iran Med. 2024-12-1

[10]
GVHD after CAR T-cell therapy post allogeneic hematopoietic cell transplantation - successfully treated by extracorporeal photopheresis.

Front Immunol. 2024-11-18

本文引用的文献

[1]
Allogeneic T Cells That Express an Anti-CD19 Chimeric Antigen Receptor Induce Remissions of B-Cell Malignancies That Progress After Allogeneic Hematopoietic Stem-Cell Transplantation Without Causing Graft-Versus-Host Disease.

J Clin Oncol. 2016-4-1

[2]
Murine allogeneic CD19 CAR T cells harbor potent antileukemic activity but have the potential to mediate lethal GVHD.

Blood. 2016-3-10

[3]
Structural Design of Engineered Costimulation Determines Tumor Rejection Kinetics and Persistence of CAR T Cells.

Cancer Cell. 2015-10-12

[4]
CAR therapy: the CD19 paradigm.

J Clin Invest. 2015-9

[5]
4-1BB costimulation ameliorates T cell exhaustion induced by tonic signaling of chimeric antigen receptors.

Nat Med. 2015-6

[6]
Going viral: chimeric antigen receptor T-cell therapy for hematological malignancies.

Immunol Rev. 2015-1

[7]
T cells expressing CD19 chimeric antigen receptors for acute lymphoblastic leukaemia in children and young adults: a phase 1 dose-escalation trial.

Lancet. 2015-2-7

[8]
Chimeric antigen receptor T cells for sustained remissions in leukemia.

N Engl J Med. 2014-10-16

[9]
Chemotherapy-refractory diffuse large B-cell lymphoma and indolent B-cell malignancies can be effectively treated with autologous T cells expressing an anti-CD19 chimeric antigen receptor.

J Clin Oncol. 2015-2-20

[10]
Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia.

Sci Transl Med. 2014-2-19

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