研究概要
异基因造血细胞移植(HCT)后复发和/或难治的急性髓系白血病(AML)通常致命。
中文摘要
异基因造血细胞移植(HCT)后复发和/或难治的急性髓系白血病(AML)通常具有致命性。既往研究中,我们证明移植后给予经工程化改造、表达高亲和力Wilms肿瘤抗原1(WT1)特异性T细胞受体(TCR C4)的EB病毒(EBV)特异性供者CD8⁺ T细胞免疫疗法,可预防高危患者AML复发。然而,在本研究中,对15名HCT后仍有活动性疾病的患者输注EBV或巨细胞病毒(CMV)特异性TCR-C4细胞,并未明确改善结局。转导TCR-C4的EBV特异性T细胞在回输后持续时间长于CMV特异性T细胞。持续存在的TCR-C4细胞偏向功能失常的NK样终末分化状态;这一状态不同于既往实体瘤靶向T细胞疗法所报告的主要耗竭程序。一名HCT后仍有活动性AML的患者,其TCR-C4细胞持续呈效应记忆表型,与TCR-C4长期持续存在和疾病控制相关。这些发现揭示了AML诱导T细胞功能障碍的复杂机制,可为制定未来应对HCT后复发的治疗策略提供依据。
展开英文摘要原文
Acute myeloid leukemia (AML) that is relapsed and/or refractory post-allogeneic hematopoietic cell transplantation (HCT) is usually fatal. In a prior study, we demonstrated that AML relapse in high-risk patients was prevented by post-HCT immunotherapy with Epstein-Barr virus (EBV)-specific donor CD8 + T cells engineered to express a high-affinity Wilms Tumor Antigen 1 (WT1)-specific T-cell receptor (T TCR-C4 ). However, in the present study, infusion of EBV- or Cytomegalovirus (CMV)-specific T TCR-C4 did not clearly improve outcomes in fifteen patients with active disease post-HCT. TCR C4 -transduced EBV-specific T cells persisted longer post-transfer than CMV-specific T cells. Persisting T TCR-C4 skewed towards dysfunctional natural killer-like terminal differentiation, distinct from the dominant exhaustion programs reported for T-cell therapies targeting solid tumors . In one patient with active AML post-HCT, a sustained T TCR-C4 effector-memory profile correlated with long-term T TCR-C4 persistence and disease control. These findings reveal complex mechanisms underlying AML-induced T-cell dysfunction, informing future therapeutic strategies for addressing post-HCT relapse.
论文信息
- 作者
- Mazziotta F、Martin LE、Eagan DN、Bar M、Kinsella S、Paulson KG、Voillet V、Lahman MC
- 单位
- Program in Immunology, Fred Hutchinson Cancer Center, Seattle, WA, USA.United States
- 文献类型
- 预印本
- 期刊
- medRxiv : the preprint server for health sciences2024 Dec 16