BioOncology Watch

Timely Information for Practicing Physicians

 

JUNE 2000

Graft-versus-Host Disease (GVHD)

Granulocyte-colony stimulating factor (G-CSF) mobilization of dendritic cells (DCs).  Mario Arpinati and associates analyzed blood, leukapheresis, and bone marrow samples from normal and G-CSF treated human donors to study the effects of G-CSF on the DC population.  G-CSF treatments (n=13) increased peripheral blood DC2 counts (lymphoid DC which drive T-cell differentiation to B-cell stimulating T helper 2 [Th2] cells) and did not alter DC1 counts (myeloid DC which drive T-cell differentiation to cytotoxic T lymphocyte generating T helper 1 [Th1] cells) compared to normal samples (n=9).  In addition, G-CSF mobilized PBSC transplants (n=7) were found to contain higher doses of DC2 than marrow transplants (n=15) (p=.006), whereas the dose of DC1 was comparable.  These results may explain why overwhelming acute GVHD does not develop after PBSC transplantation.  Furthermore, altering the DC2 to DC1 ratio by G-CSF mobilization provides a potential strategy to enhance the survival of organ grafts.  (Arpinati M, et al.  Blood 2000;95:2484-2490)

 

Monoclonal antibody (mAb) treatment.  Blockade of the CD40-CD154 pathway using anti-CD154 monoclonal antibody (mAb) has been shown to inhibit the graft-versus-host disease (GVHD) activity of alloreactive CD8+ T cells. Edward Seung and colleagues used a conditioning regimen of sublethal radiation with or without anti-CD154 mAb therapy (to block the CD40-CD154 interaction) in BALB/c mice transplanted with allogeneic C57BL/6 mouse bone marrow.  In contrast to mice treated with radiation only, mice given anti-CD154 mAb (n=9) did not develop GVHD and accepted donor-origin, but not third party, skin allografts.  This marrow transplantation protocol also allowed all chimeric NOD/Lt mice with autoimmune diabetes (n=19) to accept pancreatic islet allografts.  Nobuhiro Tsukada et al also used a murine model of acute GVHD to study the potential effectiveness of blocking the CD134-CD134L (member of TNF family) interaction by the administration of an anti-CD134L mAb.  Anti-CD134L mAb therapy (n=30) increased survival and reduced the signs of acute GVHD compared to those mice receiving radiation and control IgG (n=30).  An assay of T-cell proliferation showed a marked hyporesponsiveness to host alloantigen in samples from mice treated with anti-CD134L mAb.  Although these therapies have yet to be evaluated in tumor models, these results suggest that mAb therapy may ameliorate GVHD and facilitate transplantation tolerance induction.  (Seung E, et al. Blood 2000;95:2175-2182 and Tsukada N, et al.  Blood 2000;95:2434-2439)

 

Leukemia

Cytotoxic T lymphocytes (CTL) specific for the Wilm’s tumor gene encoded transcription factor (WT1).  Elevated levels of WT1 expression have been observed in CD34+ progenitor cells obtained from patients with acute and chronic myelogenous leukemias.  Liquan Gao et al. investigated WT1 as a target for CTLs.  They generated peptide-specific CTLs from MHC-mismatched donors and a 9 amino acid peptide segment of WT1 (P126 peptide) was selected as the CTL target because it binds to HLA-A0201 class I molecules.  The generated CTLs killed leukemia CD34+ cells obtained from leukemic cell lines and from patients with chronic myelogenous leukemia.  The CTLs were specific for leukemic progenitor cells and HLA-A0202-negative cells, CD34- cells, and normal CD34+ cells were not effected.  These results show that the WT1 antigen is capable of directing CTL responses selectively against leukemic progenitor cells.  (Gao L, et al.  Blood 2000;95:2198-2203)

 

Tumor Cell Vaccination

Enhancement of graft-versus-tumor (GVT) activity.  Larry Anderson and colleagues conducted animal experiments to investigate whether post-transplant immunization of allogeneic bone marrow transplantation (BMT) recipients could increase GVT activity.  Donor (C3H.SW mice) BM and splenocytes were transplanted into MHC matched but minor histocompatibility antigen mismatched recipients (C57BL/6 mice) and one month later the recipients were immunized against either myelomonocytic leukemia cells (the C1498 cell line) or fibrosarcoma cells (the 205 cell line) by subcutaneously administered tumor cell vaccinations.  Micrometastases were established by tumor cell intravenous injection 10-14 days after vaccination.  In both tumor models, recipients treated with multiple vaccinations had longer survival (p<.0001) and evidence of protection against tumor growth compared to non-immune control animals. Immunity was tumor specific and no exacerbation of graft-versus-host disease (GVHD) was observed.  These experiments show that post-transplant tumor immunization can induce GVT activity without increasing GVHD.  (Anderson LD, et al.  Blood 2000;95:2426-2433)

 

Cellular immune response mechanisms.  Two recent studies further define the role of Fas-mediated mechanisms in antitumor cellular immune responses.  Antoni Ribas and coworkers demonstrated that C3H mice, but not C57BL/6 mice, receiving multiple vaccinations with dendritic cells transduced with the MART-1 gene unexpectedly had decreased tumor protection compared to those mice receiving a single vaccination.  This impaired immune response was associated with an altered cytokine profile and was abrogated in studies performed in Fas receptor-negative C3H mice.  Thus, the findings in the C3H mice may be attributed to a Fas-receptor mediated clearance of antigen-specific type 1 cytokine-producing cells and indicate that different individuals may respond differently to tumor immunization according to HLA alleles, tumor antigens, and non-MHC genes.  In a second study, Masaki Yasukawa et al. generated alloantigen-specific CD4+ and CD8+ lymphocytes with Fas -/- or Fas +/- cell lines established from B-lymphocytes obtained from members of a Fas-deficient family.  The cytotoxicity exerted by the CD4+ and CD8+ CTLs against Fas -/- and Fas +/- cells was similar and was suppressed by an inhibitor of perforin-mediated cytotoxicity (concanamycin A).  These data show that the cytotoxicity of human CD4+ and CD8+ CTLs is not mediated by the Fas/Fas ligand system, but is accomplished via granule exocytosis.  (Ribas A, et al.  Cancer Res 2000; 60:2218-2224 and Yasukawa M, et al.  Blood 2000;95:2352-2355) 

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