决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:CD16xCD33 Bispecific Killer Cell Engager (BiKE) as potential immunotherapeutic in pediatric patients with AML and biphenotypic ALL.
CD16xCD33 Bispecific Killer Cell Engager (BiKE) as potential immunotherapeutic in pediatric patients with AML and biphenotypic ALL.
尽管已有诸如CAR-T 细胞和双特异性抗 CD19/CD3 抗体等新颖且有前景的抗 CD19 靶向免疫疗法,但复发和耐药仍是约 30% 至 60% 患者面临的重大挑战。
与儿童急性髓系白血病(AML)类似,双表型急性淋巴细胞白血病(ALL)是一种罕见、复杂且预后不良的疾病亚型,特征之一是细胞表面表达CD33。尽管抗CD19CAR-T 细胞以及抗CD19/CD3双特异性抗体等新型免疫疗法前景良好,约30%~60%的患者仍会复发或出现耐药。本研究评估全人源化CD16×CD33双特异性杀伤细胞衔接器(BiKE)对儿童CD33阳性急性白血病的潜在作用,并检测其能否增强NK细胞对CD33阳性AML和双表型ALL原始细胞的效应功能。健康志愿者的原代NK细胞经CD16×CD33 BiKE刺激后,对CD33阳性细胞系的细胞毒作用、脱颗粒和细胞因子产生均增加。此外,BiKE处理显著提高了NK细胞针对原代ALL和AML靶细胞的脱颗粒反应以及IFN-γ和TNF-α产生。值得注意的是,白血病患者自身的NK细胞也能从BiKE治疗中获益,效应功能得到恢复,但幅度不如健康供者来源的NK细胞。尤其是穿孔素和颗粒酶表达偏低的患者,即使使用BiKE,其细胞毒功能仍受损。因此,对于存在固有NK细胞缺陷的患者,联合CD16×CD33 BiKE和异基因NK细胞治疗可能是一种有前景的策略。综上,CD16×CD33 BiKE可增强NK细胞针对儿童AML及双表型ALL原始细胞的效应功能,有望用于支持维持治疗,或作为造血干细胞移植前巩固化疗的衔接方案。
Similar to pediatric acute myeloid leukemia (AML) the subgroup of biphenotypic acute lymphoblastic leukemia (ALL) is a rare complex entity with adverse outcome, characterized by the surface expression of CD33. Despite novel and promising anti-CD19 targeted immunotherapies such as chimeric antigen receptor T cells and bispecific anti-CD19/CD3 antibodies, relapse and resistance remain a major challenge in about 30% to 60% of patients. To investigate the potential role of the fully humanized bispecific antibody CD16 CD33 (BiKE) in children with CD33 + acute leukemia, we tested whether the reagent was able to boost NK cell effector functions against CD33 + AML and biphenotypic ALL blasts. Stimulation of primary NK cells from healthy volunteers with 16 33 BiKE led to increased cytotoxicity, degranulation and cytokine production against CD33 + cell lines. Moreover, BiKE treatment significantly increased degranulation, IFN- and TNF- production against primary ALL and AML targets. Importantly, also NK cells from leukemic patients profited from restoration of effector functions by BiKE treatment, albeit to a lesser extent than NK cells from healthy donors. In particular, those patients with low perforin and granzyme expression showed compromised cytotoxic function even in the presence of BiKE. In patients with intrinsic NK cell deficiency, combination therapy of CD16xCD33 BiKE and allogeneic NK cells might thus be a promising therapeutic approach. Taken together, CD16xCD33 BiKE successfully increased NK cell effector functions against pediatric AML and biphenotypic ALL blasts and constitutes a promising new option for supporting maintenance therapy or "bridging" consolidation chemotherapy before hematopoietic stem cell transplantation.
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