scholarly journals Characterisation of B killer cell immunoglobulin-like receptor genes and telomeric and centromeric motifs in hematopoietic stem cell transplantation donors in Vojvodina, Serbia

Genetika ◽  
2017 ◽  
Vol 49 (1) ◽  
pp. 345-354
Author(s):  
Dusica Ademovic-Sazdanic ◽  
Svetlana Vojvodic ◽  
S. Popovic ◽  
N. Konstantinidis
Keyword(s):  
Relapse Prevention ◽  
Hematological Malignancies ◽  
Killer Cell ◽  
Simple Algorithm ◽  
Hematopoietic Stem ◽  
Graft Versus Host ◽  
Kir Genes ◽  
Graft Versus Leukemia ◽  
Kir Gene ◽  
Kir Genotypes

The outcome of HSCT is strongly in?uenced by the genetic similarity or identity in the HLA genes that affects the incidence of graft-versus-host disease (GvHD). Successful allogeneic HSCT, however, depends also on T-cell mediated graft-versus-leukemia (GvL) effect, in which donor-derived T cells and natural killer (NK) cells kill these malignant cells in the patient, therefore playing a crucial role in relapse prevention. The aim of this study was to make the predictive analysis of the structure and distribution of B KIR alleles and centromeric and telomeric KIR genotypes in HSCT donors in Vojvodina with regard to their contribution to protection from relapse. A total of 124 first-degree relatives of patients with hematological malignancies were examined for the presence or absence of 15 KIR genes by using of PCR-SSO technique with Luminex xMap technology. The percentage of individuals carrying each KIR gene, centromeric and telomeric KIR haplotypes and genotypes was determined by direct counting. Sixty two percent of the HSCT donors in Vojvodina carry A KIR haplotype, while nearly 38% carry B KIR haplotype. The distribution of B KIR genes showed that among 124 studied HSCT donors, 31(25%) do not carry none of the KIR genes belonging to B group, 71.77% of donors have two or more B KIR genes, 61.29% of them carry KIR 2DL2 and 2DS2 or more B KIR genes. The analysis of centromeric and telomeric KIR genotypes, showed that Cen-A1/Tel-A1 genotype had a highest frequency of 51.47% and Cen-B2/Tel-B1 the lowest frequency of 1.30%. The usage of donor KIR B gene content and centromeric and telomeric KIR gene structure could be used in development of a simple algorithm to identify donors who will provide the most protection against the relapse in related HSC transplants.

scholarly journals Reduced dose of PTCy followed by adjuvant α-galactosylceramide enhances GVL effect without sacrificing GVHD suppression

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Nakamura ◽  
Yusuke Meguri ◽  
Shuntaro Ikegawa ◽  
Takumi Kondo ◽  
Yuichi Sumii ◽  
...  
Keyword(s):  
T Cells ◽  
Stem Cell ◽  
T Cell Subsets ◽  
Inkt Cells ◽  
Early Recovery ◽  
Hematopoietic Stem ◽  
Graft Versus Host ◽  
Reduced Dose ◽  
Graft Versus Leukemia ◽  
Novel Strategy

AbstractPosttransplantation cyclophosphamide (PTCy) has become a popular option for haploidentical hematopoietic stem cell transplantation (HSCT). However, personalized methods to adjust immune intensity after PTCy for each patient’s condition have not been well studied. Here, we investigated the effects of reducing the dose of PTCy followed by α-galactosylceramide (α-GC), a ligand of iNKT cells, on the reciprocal balance between graft-versus-host disease (GVHD) and the graft-versus-leukemia (GVL) effect. In a murine haploidentical HSCT model, insufficient GVHD prevention after reduced-dose PTCy was efficiently compensated for by multiple administrations of α-GC. The ligand treatment maintained the enhanced GVL effect after reduced-dose PTCy. Phenotypic analyses revealed that donor-derived B cells presented the ligand and induced preferential skewing to the NKT2 phenotype rather than the NKT1 phenotype, which was followed by the early recovery of all T cell subsets, especially CD4+Foxp3+ regulatory T cells. These studies indicate that α-GC administration soon after reduced-dose PTCy restores GVHD-preventing activity and maintains the GVL effect, which is enhanced by reducing the dose of PTCy. Our results provide important information for the development of a novel strategy to optimize PTCy-based transplantation, particularly in patients with a potential relapse risk.

Excessive Rate of Late Infections and Treatment Related Mortality Associated with the Use of Alemtuzumab in Reduced Intensity Conditioning for Allogeneic Hematopoietic Stem Cell Transplantation: Results of a Prospective Trial.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2230-2230
Author(s):  
Munira Shabbir ◽  
Luciano J Costa ◽  
Christine Schaub ◽  
Carrie Maxwell ◽  
Theo Fouts ◽  
...  
Keyword(s):  
Hematological Malignancies ◽  
Acute Gvhd ◽  
Infectious Complications ◽  
Unrelated Donor ◽  
Reduced Intensity Conditioning ◽  
Myeloablative Conditioning ◽  
Hematopoietic Stem ◽  
Graft Versus Host ◽  
Group A ◽  
Related Mortality

Abstract Abstract 2230 Poster Board II-207 Background: Reduced intensity conditioning (RIC) for allogeneic hematopoietic stem cell (HSC) transplantation is a well established therapy for patients with advanced hematological malignancies who are not suitable candidates for fully myeloablative conditioning. The use of alemtuzumab as part of RIC has been associated with decrease in incidence and severity of graft versus host disease (GVHD), particularly in unrelated donor transplants. Methods: This is a single center, prospective study. Patients with relapsed or refractory hematological malignancies who were not candidates for fully myeloablative conditioning regimens received an non-alemtuzumab (nA) containing RIC regimen or an alemtuzumab-containing regimen (A) based on the use of a matched sibling or an allele-matched unrelated donor, respectively. Patients in the nA group were conditioned with either Fludarabine 30mg/m2/day for 5 days and total body irradiation 200cG or Fludarabine 25mg/m2/day for 5 days and Melphalan 70mg/m2/day for 2 days. Patients in the A group received alemtuzumab 20 mg/m2/day for 2 days, Fludarabine 30mg/m2/day for 5 days and Melphalan 70mg/m2/day for 2 days. All patients received peripheral blood HSC grafts. Prophylaxis against graft versus host disease with cyclosporine and mycophenolate mofetil as well as infectious disease prophylaxis and supportive care guidelines were standard across both groups. Results: From January 2003 to March 2009, 56 patients were enrolled in the study and 50 patients who actually received a HSCT are the subject of this analysis. Twenty nine patients were in group nA and 21 in group A. Median age of the patients in the entire cohort was 55 years (range 14-65). Eighteen patients had AML, 12 NHL, 8 MDS, 6 CML, 3 CLL and 3 MM. Twenty-three patients were considered to be at high-risk for post transplant relapse (45% of group nA vs. 47% of group A, P= 0.84). All patients in group nA had hematological engraftment while 2 patients in A (9.5%) failed to engraft. Despite the fact that all patients in group A received a transplant from an unrelated donor, the incidence of severe (grades C or D) acute GVHD was significantly higher in group nA (20.7% vs. 0%, P=0.03). Day 100 mortality was similar between the 2 groups (20.7% for nA vs 33.1% for A, P=0.31). Cumulative incidence of progression did not differ between the two groups (P=0.7) while the cumulative incidence of treatment related mortality was higher in group A (P=0.02, Figure 1). Both median overall survival (OS) (44.1 vs. 5.3 months; P=0.01, figure 2) and progression-free survival (PFS) (8.7 vs 5.3 months, P= 0.02) were superior in group nA. Cox regression analysis including conditioning regimen, age and risk of post-transplant relapse showed that conditioning with alemtuzumab was the only variable significantly associated with inferior OS (RR 2.8, P=0.009) and PFS (RR 2.42, P= 0.01). Group A had a higher incidence of late (after Day 100) infectious complications resulting in death (43% vs.10%, p=0.01). Conclusion: Even though alemtuzumab-based RIC in unrelated HSCT has a protective effect against acute GVHD and risk of D+100 TRM comparable with non-alemtuzumab containing RIC regimens in related donor transplant, its beneficial effect is overcome by excessive late infectious complications. Disclosures: Fouts: Genzime: Consultancy.

scholarly journals Comparison of alemtuzumab, anti-thymocyte globulin, and post-transplant cyclophosphamide for graft-versus-host disease and graft-versus-leukemia in murine models

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245232
Author(s):  
Kiyomi Mashima ◽  
Iekuni Oh ◽  
Ken Fujiwara ◽  
Junko Izawa ◽  
Norihito Takayama ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Graft Versus Host Disease ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
Post Transplant ◽  
Graft Versus Leukemia ◽  
Graft Versus Leukemia Effect

Graft-versus-host disease is a major complication after allogeneic hematopoietic stem cell transplantation for hematological malignancies. Immunosuppressive drugs, such as anti-thymocyte globulin, alemtuzumab, and post-transplant cyclophosphamide, have been used to prevent graft-versus-host disease in HLA-mismatched haploidentical hematopoietic stem cell transplantation. Here, we investigated whether these drugs could ameliorate graft-versus-host disease without diminishing the graft-versus-leukemia effect by using a xenogeneic transplanted graft-versus-host disease/graft-versus-leukemia model. Anti-thymocyte globulin treatment diminished graft-versus-host disease symptoms, completely depleted the infiltration of inflammatory cells in the liver and intestine, and led to prolonged survival. By contrast, improvement after post-transplant cyclophosphamide treatment remained minimal. Alemtuzumab treatment modestly prolonged survival despite an apparent decrease of Tregs. In the graft-versus-leukemia model, 1.5 to 2.0 mg/kg of anti-thymocyte globulin and 0.6 to 0.9 mg/kg of alemtuzumab reduced graft-versus-host disease with minimal loss of graft-versus-leukemia effect. Mice treated with 400 mg/kg of post-transplant cyclophosphamide did not develop graft-versus-host disease or leukemia, but it was difficult to evaluate the graft-versus-leukemia effect due to the sensitivity of A20 cells to cyclophosphamide. Although the current settings provide narrow optimal therapeutic windows, further studies are warranted to maximize the benefits of each immunosuppressant.

Cytomegalovirus (CMV) Reactivation after T-Cell Replete Reduced-Intensity Conditioning (RIC) Allogeneic Hematopoietic Stem Cell Transplantation (AHSCT) Correlates with Donor KIR Genotype.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2974-2974
Author(s):  
Ronald Sobecks ◽  
Medhat Askar ◽  
Dawn Thomas ◽  
Lisa Rybicki ◽  
Matt Kalaycio ◽  
...  
Keyword(s):  
T Cell ◽  
Multivariable Analysis ◽  
Hla Class I ◽  
Hematopoietic Stem ◽  
Kir Genes ◽  
Sibling Donor ◽  
Hla Class I Molecules ◽  
Matched Sibling ◽  
Cmv Reactivation ◽  
Kir Genotypes

Abstract CMV remains the most common viral infection after AHSCT. NK and T cells provide protection against CMV reactivation. The interaction of inhibitory killer immunoglobulin-like receptors (KIRs) with target cell HLA class I molecules regulates NK cells and some T cell populations. Donor activating KIR genotype has been suggested to influence CMV reactivation after myeloablative AHSCT (Cook et al, Blood2006;107:1230–1232). However, the effect of donor activating or inhibitory KIR genotype on CMV reactivation after T-cell replete RIC AHSCT has not been reported. We analyzed 64 consecutive patients (pts) who underwent T-cell replete matched sibling donor RIC AHSCT at our institution from 1/16/00-4/24/07 with fludarabine and low-dose total body irradiation (200 cGy: 36 pts; 400 cGy: 28 pts). All pts received cyclosporine and mycophenolate mofetil for GVHD prophylaxis. CMV monitoring was performed by polymerase chain reaction testing. 49 (77%) pts were CMV seropositive or had a CMV seropositive donor; 25/49 (51%) had CMV reactivation post-AHSCT. 15 (23%) pts were CMV seronegative along with their donors and 1 (7%) of them had CMV reactivation. Donor activating KIR genotypes (KIR2DS1, KIR2DS2, KIR2DS3, KIR2DS4, KIR2DS5, KIR3DS1) and inhibitory genotypes (KIR2DL1, KIR2DL2, KIR2DL3, KIR3DL1, KIR3DL2) were determined by PCR-SSOP and/or PCR-SSP. Patient HLA KIR ligands including HLA-Cw groups C1 or C2, HLA-Bw4 and HLA-A3/11 (reviewed in Farag et al Blood2002; 100:1935–1947) and donor inhibitory KIR genotypes were analyzed. Missing patient KIR ligand was observed in 15 (23%) of the C1 group, 27 (42%) of the C2 group, 25 (39%) of the HLA-Bw4+ pts and 43 (67%) of the HLA-A3/11+ pts. There were no differences observed for CMV reactivation between any of these groups when comparing those with or without missing ligands. However, when the number of donor activating KIRs were considered a difference in CMV reactivation patterns was appreciated. Pts whose donor KIR genotype contained 5 or 6 activating KIR genes (N=16) had less CMV reactivation compared to those with only 1 to 4 activating KIR genes (N=48) (19% vs. 48%). This finding remained significant on multivariable analysis (p=0.038). No specific activating KIR was found to be associated with CMV reactivation. There were no differences between the groups (5–6 vs. 1–4 activating KIR genes) with regards to patient/donor CMV seropositivity, age, diagnoses, gender, race, number of prior chemotherapy regimens, prior radiation, time from diagnosis to RIC AHSCT, TBI dose, donor to patient gender, CD34+ and CD3+ cell doses. We conclude that donor activating KIR genotype influences CMV reactivation after matched sibling donor T-cell replete RIC AHSCT. These results may guide the selection of donors as well as identify patients who may benefit from closer CMV monitoring and additional strategies to prevent CMV reactivation post transplant. Figure Figure

Y-Chromosome Genes Strongly Expressed in Acute Myeloid Leukaemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4901-4901
Author(s):  
Antonio Gallo ◽  
Dagmar Bund ◽  
Rebecca Mindnich ◽  
Raymund Buhmann ◽  
Helga Schmetzer ◽  
...  
Keyword(s):  
Binding Capacity ◽  
Graft Versus Host Reaction ◽  
Immune Recognition ◽  
Hematopoietic Stem ◽  
Substantial Impact ◽  
Minor Histocompatibility Antigens ◽  
Graft Versus Host ◽  
Graft Versus Leukemia ◽  
293 Cells ◽  
Proteasomal Cleavage

Abstract In hematopoietic stem cell transplantation (HSCT) the gender of the donors has a substantial impact on the relapse rate, graft-versus-host reaction and overall therapeutic outcome. In several studies including our own HLA-haploidentical setting female to male transplantation seemed to be superior to other gender combinations, suggesting the dominance of Y-encoded minor histocompatibility antigens for graft-versus-leukemia reactions. In order to explore the therapeutic possibilities we compared the Y-chromosomal gene expression between isolated AML blasts (FAB M4/M5) and isolated CD14+ cells from healthy male donors. RNA was isolated and subsequently analyzed by low density arrays (LDAs), a real time-PCR based method. This way we could identify four Y-encoded genes found to be strongly up-regulated in the AML samples. Bcorl2, a pseudogene; pcdh11y, known to be involved in acquisition of apoptotic resistance in prostate cancer; tgif2ly and vcy, both putative transcription factors. The genes were cloned in plasmids and transferred in 293 cells. The expression of these proteins was analyzed by western blot. Biostatistical soft ware was used to predict the proteasomal cleavage site and binding capacity to HLA-A 0201 of these peptides. Five peptides were found to bind strongly to HLA-A 0201; they are now studied for recognition by female T cells. In summary, the genes identified might be involved in the immune recognition of AML blasts and other tumor cells. These peptides may help to identify and select T memory cells specific for AML blasts.

Nanoparticle-Encapsulated Allogeneic T Cells Mitigate Graft-Versus-Host Disease but Retain Graft-Versus-Leukemia Activity

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3820-3820
Author(s):  
Lingling Zhang ◽  
Shuting Zhao ◽  
Steven M. Devine ◽  
Xiaoming He ◽  
Jianhua Yu
Keyword(s):  
T Cells ◽  
Graft Versus Host Disease ◽  
Conflicts Of Interest ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
Electrostatic Deposition ◽  
Graft Versus Leukemia ◽  
Donor T Cells

Abstract Allogeneic hematopoietic stem cell transplantation (HSCT) has curative potential for hematological malignancies, but is often associated with life-threatening complications including graft-versus-host disease (GVHD). The graft-versus-leukemia (GVL) activity which accompanies HSCT is responsible for eradication of tumor cells and prevention of relapse. GVHD and GVL are usually associated with each other and the separation of the two activities occurs in limited circumstances. In this study, we aimed to mitigate GVHD but retain GVL through transplantation of allogeneic T cells encapsulated with bio-degradable nanoparticle materials. For the above purpose, donor T cells were encapsulated with chitosan and alginate through layer-by-layer coating using electrostatic deposition. Encapsulated donor T cells were characterized in vitro, and their ability to inhibit GVHD and retain GVL was determined in vivo after being transplanted together with non-encapsulated donor bone marrow (BM) cells in a C57BL/6 → BALB/c HSCT mouse model. We found 85.7% of donor T cells were successfully encapsulated by the above method (Fig 1A). In vitro studies showed that the encapsulation did not change the phenotype of T cells as defined through the following parameters: size, viability, proliferation, antibody binding, cytokine secretion, and cytotoxicity of T cells (Fig. 1B and data not shown). Mice transplanted with encapsulated allogeneic T cells exhibited less severe acute GVHD and prolonged survival (Fig. 1 C-E). The mice showed a lower GVHD score, less liver damage, a smaller CD8/CD4 T cell ratio, and a higher number of donor BM-derived cells following transplantation with encapsulated donor T cells (Fig. 1 C-E and data not shown). When this GVHD model was combined with implantation of A20 lymphoma cells, GVL of encapsulated T cells was not compromised, while GVHD was still suppressed and the mouse survival also prolonged (Figure 2). In summary, nanoencapsulation of T cells with bio-degradable materials attenuated the severity of GVHD but retained GVL, presenting a novel and potentially safer and effective approach of allogeneic HSCT for future clinical application. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.

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