Bialek-Waldmann Julia K, Domning Sabine, Esser Ruth, Glienke Wolfgang, Mertens Mira, Aleksandrova Krasimira, Arseniev Lubomir, Kumar Suresh, Schneider Andreas, Koenig Johannes, Theobald Sebastian J, Tsay Hsin-Chieh, Cornelius Angela D A, Bonifacius Agnes, Eiz-Vesper Britta, Figueiredo Constanca, Schaudien Dirk, Talbot Steven R, Bleich Andre, Spineli Loukia M, von Kaisenberg Constantin, Clark Caren, Blasczyk Rainer, Heuser Michael, Ganser Arnold, Köhl Ulrike, Farzaneh Farzin, Stripecke Renata
Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.
Laboratory of Regenerative Immune Therapies Applied, REBIRTH-Research Center for Translational Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany.
Mol Ther Methods Clin Dev. 2021 Apr 9;21:621-641. doi: 10.1016/j.omtm.2021.04.004. eCollection 2021 Jun 11.
Acute myeloid leukemia (AML) patients with minimal residual disease and receiving allogeneic hematopoietic stem cell transplantation (HCT) have poor survival. Adoptive administration of dendritic cells (DCs) presenting the Wilms tumor protein 1 (WT1) leukemia-associated antigen can potentially stimulate T and B cell development to harness the graft-versus-leukemia (GvL) effect after HCT. We established a simple and fast genetic modification of monocytes for simultaneous lentiviral expression of a truncated WT1 antigen (tWT1), granulocyte macrophage-colony-stimulating factor (GM-CSF), and interferon (IFN)-α, promoting their self-differentiation into potent "induced DCs" (iDCtWT1). A tricistronic integrase-defective lentiviral vector produced under good manufacturing practice (GMP)-like conditions was validated. Transduction of CD14 monocytes isolated from peripheral blood, cord blood, and leukapheresis material effectively induced their self-differentiation. CD34 cell-transplanted Nod.Rag.Gamma (NRG)- and Nod.Scid.Gamma (NSG) mice expressing human leukocyte antigen (HLA)-A∗0201 (NSG-A2)-immunodeficient mice were immunized with autologous iDCtWT1. Both humanized mouse models showed improved development and maturation of human T and B cells in the absence of adverse effects. Toward clinical use, manufacturing of iDCtWT1 was up scaled and streamlined using the automated CliniMACS Prodigy system. Proof-of-concept clinical-scale runs were feasible, and the 38-h process enabled standardized production and high recovery of a cryopreserved cell product with the expected identity characteristics. These results advocate for clinical trials testing iDCtWT1 to boost GvL and eradicate leukemia.
患有微小残留病且接受异基因造血干细胞移植(HCT)的急性髓系白血病(AML)患者生存率较低。过继给予呈递威尔姆斯瘤蛋白1(WT1)白血病相关抗原的树突状细胞(DC)可能会刺激T细胞和B细胞发育,从而在HCT后利用移植物抗白血病(GvL)效应。我们建立了一种简单快速的单核细胞基因改造方法,用于同时通过慢病毒表达截短的WT1抗原(tWT1)、粒细胞巨噬细胞集落刺激因子(GM-CSF)和干扰素(IFN)-α,促使它们自我分化为有效的“诱导DC”(iDCtWT1)。验证了在类似药品生产质量管理规范(GMP)条件下生产的三顺反子整合酶缺陷型慢病毒载体。从外周血、脐血和白细胞分离材料中分离出的CD14单核细胞经转导后有效诱导了它们的自我分化。用自体iDCtWT1免疫移植了表达人白细胞抗原(HLA)-A∗0201的CD34细胞的Nod.Rag.Gamma(NRG)和Nod.Scid.Gamma(NSG)小鼠(NSG-A2免疫缺陷小鼠)。两种人源化小鼠模型均显示人T细胞和B细胞的发育和成熟得到改善,且无不良反应。为了用于临床,使用自动化的CliniMACS Prodigy系统扩大了iDCtWT1的生产规模并简化了流程。概念验证性临床规模生产是可行的,这个38小时的流程能够实现标准化生产,并高效回收具有预期特征的冷冻保存细胞产品。这些结果支持开展临床试验来测试iDCtWT1,以增强GvL效应并根除白血病。