Results of a multicenter phase I/II trial of TCRαβ and CD19-depleted haploidentical hematopoietic stem cell transplantation for adult and pediatric patients.


Journal

Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459

Informations de publication

Date de publication:
03 2022
Historique:
received: 20 08 2021
accepted: 06 12 2021
revised: 17 11 2021
pubmed: 26 12 2021
medline: 22 4 2022
entrez: 25 12 2021
Statut: ppublish

Résumé

Hematopoietic stem cell transplantation (HSCT) from haploidentical donors is a viable option for patients lacking HLA-matched donors. Here we report the results of a prospective multicenter phase I/II trial of transplantation of TCRαβ and CD19-depleted peripheral blood stem cells from haploidentical family donors after a reduced-intensity conditioning with fludarabine, thiotepa, and melphalan. Thirty pediatric and 30 adult patients with acute leukemia (n = 43), myelodysplastic or myeloproliferative syndrome (n = 6), multiple myeloma (n = 1), solid tumors (n = 6), and non-malignant disorders (n = 4) were enrolled. TCR αβ/CD19-depleted grafts prepared decentrally at six manufacturing sites contained a median of 12.1 × 10

Identifiants

pubmed: 34952929
doi: 10.1038/s41409-021-01551-z
pii: 10.1038/s41409-021-01551-z
pmc: PMC8702395
doi:

Substances chimiques

Antigens, CD19 0
Receptors, Antigen, T-Cell, alpha-beta 0

Types de publication

Clinical Trial, Phase I Clinical Trial, Phase II Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

423-430

Informations de copyright

© 2021. The Author(s).

Références

Passweg JR, Baldomero H, Bader P, Bonini C, Duarte RF, Dufour C. et al. Use of haploidentical stem cell transplantation continues to increase: the 2015 European Society for Blood and Marrow Transplant activity survey report. Bone Marrow Transpl. 2017;52:811–7. https://doi.org/10.1038/bmt.2017.34 .
doi: 10.1038/bmt.2017.34
Or-Geva N, Reisner Y. The evolution of T-cell depletion in haploidentical stem-cell transplantation. Br J Haematol. 2016;172:667–84. https://doi.org/10.1111/bjh.13868 .
doi: 10.1111/bjh.13868 pubmed: 26684279
Reisner Y, Kapoor N, Kirkpatrick D, Pollack MS, Cunningham-Rundles S, Dupont B, et al. Transplantation for severe combined immunodeficiency with HLA-A,B,D,DR incompatible parental marrow cells fractionated by soybean agglutinin and sheep red blood cells. Blood. 1983;61:341–8.
doi: 10.1182/blood.V61.2.341.341
Aversa F, Tabilio A, Terenzi A, Velardi A, Falzetti F, Giannoni C, et al. Successful engraftment of T-cell-depleted haploidentical “three-loci” incompatible transplants in leukemia patients by addition of recombinant human granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells to bone marrow inoculum. Blood. 1994;84:3948–55.
doi: 10.1182/blood.V84.11.3948.bloodjournal84113948
Sebestyen Z, Prinz I, Déchanet-Merville J, Silva-Santos B, Kuball J. Translating gammadelta (γδ) T cells and their receptors into cancer cell therapies. Nat Rev Drug Disco. 2020;19:169–84. https://doi.org/10.1038/s41573-019-0038-z .
doi: 10.1038/s41573-019-0038-z
Kierkels GJJ, Scheper W, Meringa AD, Johanna I, Beringer DX, Janssen A, et al. Identification of a tumor-specific allo-HLA-restricted γδTCR. Blood Adv. 2019;3:2870–82. https://doi.org/10.1182/bloodadvances.2019032409 .
doi: 10.1182/bloodadvances.2019032409 pubmed: 31585951 pmcid: 6784524
Godder KT, Henslee-Downey PJ, Mehta J, Park BS, Chiang KY, Abhyankar S, et al. Long term disease-free survival in acute leukemia patients recovering with increased gammadelta T cells after partially mismatched related donor bone marrow transplantation. Bone Marrow Transpl. 2007;39:751–7. https://doi.org/10.1038/sj.bmt.1705650 .
doi: 10.1038/sj.bmt.1705650
Li Pira G, Malaspina D, Girolami E, Biagini S, Cicchetti E, Conflitti G, et al. Selective depletion of alphabeta T cells and B cells for human leukocyte antigen-haploidentical hematopoietic stem cell transplantation. A three-year follow-up of procedure efficiency. Biol Blood Marrow Transpl. 2016;22:2056–64. https://doi.org/10.1016/j.bbmt.2016.08.006 .
doi: 10.1016/j.bbmt.2016.08.006
Schumm M, Lang P, Bethge W, Faul C, Feuchtinger T, Pfeiffer M, et al. Depletion of T-cell receptor alpha/beta and CD19 positive cells from apheresis products with the CliniMACS device. Cytotherapy. 2013;15:1253–8. https://doi.org/10.1016/j.jcyt.2013.05.014 .
doi: 10.1016/j.jcyt.2013.05.014 pubmed: 23993299
Bertaina A, Merli P, Rutella S, Pagliara D, Bernardo ME, Masetti R, et al. HLA-haploidentical stem cell transplantation after removal of alphabeta+ T and B cells in children with nonmalignant disorders. Blood. 2014;124:822–6. https://doi.org/10.1182/blood-2014-03-563817 .
doi: 10.1182/blood-2014-03-563817 pubmed: 24869942
Bertaina A, Zecca M, Buldini B, Sacchi N, Algeri M, Saglio F, et al. Unrelated donor vs HLA-haploidentical alpha/beta T-cell- and B-cell-depleted HSCT in children with acute leukemia. Blood. 2018;132:2594–607. https://doi.org/10.1182/blood-2018-07-861575 .
doi: 10.1182/blood-2018-07-861575 pubmed: 30348653
Ghosh S, Schuster FR, Adams O, Babor F, Borkhardt A, Comoli P, et al. Haploidentical stem cell transplantation in DOCK8 deficiency—successful control of pre-existing severe viremia with a TCRass/CD19-depleted graft and antiviral treatment. Clin Immunol. 2014;152:111–4. https://doi.org/10.1016/j.clim.2014.03.006 .
doi: 10.1016/j.clim.2014.03.006 pubmed: 24667686
Kaynar L, Demir K, Turak EE, Ozturk CP, Zararsiz G, Gonen ZB, et al. TcRalphabeta-depleted haploidentical transplantation results in adult acute leukemia patients. Hematology. 2017;22:136–44. https://doi.org/10.1080/10245332.2016.1238182 .
doi: 10.1080/10245332.2016.1238182 pubmed: 27724812
Kharya G, Nademi Z, Leahy TR, Dunn J, Barge D, Schulz A, et al. Haploidentical T-cell alpha beta receptor and CD19-depleted stem cell transplant for Wiskott-Aldrich syndrome. J Allergy Clin Immunol. 2014;134:1199–201. https://doi.org/10.1016/j.jaci.2014.04.041 .
doi: 10.1016/j.jaci.2014.04.041 pubmed: 24985403
Lang P, Schlegel PG, Meisel R, Schulz A, Greil J, Bader P, et al. Safety and efficacy of TCRalpha/beta and CD19 depleted haploidentical stem cell transplantation following reduced intensity conditioning in children: results of a prospective multicenter phase I/II clinical trial. Bone Marrow Transpl. 2018;53:O154.
Locatelli F, Merli P, Pagliara D, Li Pira G, Falco M, Pende D, et al. Outcome of children with acute leukemia given HLA-haploidentical HSCT after alphabeta T-cell and B-cell depletion. Blood. 2017;130:677–85. https://doi.org/10.1182/blood-2017-04-779769 .
doi: 10.1182/blood-2017-04-779769 pubmed: 28588018
Mainardi C, Tumino M, Gazzola MV, Rampazzo A, Scarpa M, Messina C. TCRalphabeta CD19 depletion in allogeneic haematopoietic stem cell transplantation performed for Hurler syndrome. Bone Marrow Transpl. 2016;51:438–9. https://doi.org/10.1038/bmt.2015.258 .
doi: 10.1038/bmt.2015.258
Maschan M, Shelikhova L, Ilushina M, Kurnikova E, Boyakova E, Balashov D, et al. TCR-alpha/beta and CD19 depletion and treosulfan-based conditioning regimen in unrelated and haploidentical transplantation in children with acute myeloid leukemia. Bone Marrow Transpl. 2016;51:668–74. https://doi.org/10.1038/bmt.2015.343 .
doi: 10.1038/bmt.2015.343
Tumino M, Mainardi C, Pillon M, Calore E, Gazzola MV, Destro R, et al. Haploidentical TCR A/B and B-cell depleted hematopoietic SCT in pediatric SAA and aspergillosis. Bone Marrow Transpl. 2014;49:847–9. https://doi.org/10.1038/bmt.2014.58 .
doi: 10.1038/bmt.2014.58
Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transpl. 2009;15:1628–33. https://doi.org/10.1016/j.bbmt.2009.07.004 .
doi: 10.1016/j.bbmt.2009.07.004
Jagasia MH, Greinix HT, Arora M, Williams KM, Wolff D, Cowen EW, et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group report. Biol Blood Marrow Transpl. 2015;21:389–401.e381. https://doi.org/10.1016/j.bbmt.2014.12.001 .
doi: 10.1016/j.bbmt.2014.12.001
Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, et al. 1994 Consensus Conference on acute GVHD grading. Bone Marrow Transpl. 1995;15:825–8.
Holtan SG, DeFor TE, Lazaryan A, Bejanyan N, Arora M, Brunstein CG, et al. Composite end point of graft-versus-host disease-free, relapse-free survival after allogeneic hematopoietic cell transplantation. Blood. 2015;125:1333–8. https://doi.org/10.1182/blood-2014-10-609032 .
doi: 10.1182/blood-2014-10-609032 pubmed: 25593335 pmcid: 4335084
Fuchs EJ. Human leukocyte antigen-haploidentical stem cell transplantation using T-cell-replete bone marrow grafts. Curr Opin Hematol. 2012;19:440–7. https://doi.org/10.1097/MOH.0b013e32835822dc .
doi: 10.1097/MOH.0b013e32835822dc pubmed: 22954723
Reisner Y, Hagin D, Martelli MF. Haploidentical hematopoietic transplantation: current status and future perspectives. Blood. 2011;118:6006–17. https://doi.org/10.1182/blood-2011-07-338822 .
doi: 10.1182/blood-2011-07-338822 pubmed: 21921045
Roy DC, Walker I, Maertens J, Lewalle P, Olavarria E, Selleslag D, et al. ATIR101 administered after T-cell-depleted haploidentical HSCT reduces NRM and improves overall survival in acute leukemia. Leukemia. 2020;34:1907–23. https://doi.org/10.1038/s41375-020-0733-0 .
doi: 10.1038/s41375-020-0733-0 pubmed: 32047237 pmcid: 7326707
Sahasrabudhe K, Otto M, Hematti P, Kenkre V. TCR αβ+/CD19+ cell depletion in haploidentical hematopoietic allogeneic stem cell transplantation: a review of current data. Leuk Lymphoma. 2019;60:598–609. https://doi.org/10.1080/10428194.2018.1485905 .
doi: 10.1080/10428194.2018.1485905 pubmed: 30187806
Federmann B, Bornhauser M, Meisner C, Kordelas L, Beelen DW, Stuhler G, et al. Haploidentical allogeneic hematopoietic cell transplantation in adults using CD3/CD19 depletion and reduced intensity conditioning: a phase II study. Haematologica. 2012;97:1523–31. https://doi.org/10.3324/haematol.2011.059378 .
doi: 10.3324/haematol.2011.059378 pubmed: 22491731 pmcid: 3487553
Federmann B, Hägele M, Pfeiffer M, Wirths S, Schumm M, Faul C, et al. Immune reconstitution after haploidentical hematopoietic cell transplantation: impact of reduced intensity conditioning and CD3/CD19 depleted grafts. Leukemia. 2011;25:121–9. https://doi.org/10.1038/leu.2010.235 .
doi: 10.1038/leu.2010.235 pubmed: 20944677
Eyrich M, Lang P, Lal S, Bader P, Klingebiel T, Handgretinger R, et al. A prospective analysis of the pattern of immune reconstitution following transplantation of HLA-disparate hematopoietic stem cells from parental donors. Br J Haematol. 2001;114:422–32.
doi: 10.1046/j.1365-2141.2001.02934.x
Rambaldi B, Kim HT, Reynolds C, Chamling Rai S, Arihara Y, Kubo T, et al. Impaired T- and NK-cell reconstitution after haploidentical HCT with posttransplant cyclophosphamide. Blood Adv. 2021;5:352–64. https://doi.org/10.1182/bloodadvances.2020003005 .
doi: 10.1182/bloodadvances.2020003005 pubmed: 33496734 pmcid: 7839379
Stocker N, Gaugler B, Labopin M, Farge A, Ye Y, Ricard L, et al. High-dose post-transplant cyclophosphamide impairs γδ T-cell reconstitution after haploidentical haematopoietic stem cell transplantation using low-dose antithymocyte globulin and peripheral blood stem cell graft. Clin Transl Immunol. 2020;9:e1171. https://doi.org/10.1002/cti2.1171 .
doi: 10.1002/cti2.1171
Sanz J, Montoro J, Solano C, Valcárcel D, Sampol A, Ferrá C, et al. Prospective randomized study comparing myeloablative unrelated umbilical cord blood transplantation versus HLA-haploidentical related stem cell transplantation for adults with hematologic malignancies. Biol Blood Marrow Transpl. 2020;26:358–66. https://doi.org/10.1016/j.bbmt.2019.10.014 .
doi: 10.1016/j.bbmt.2019.10.014
Boeckh M, Nichols WG, Papanicolaou G, Rubin R, Wingard JR, Zaia J. Cytomegalovirus in hematopoietic stem cell transplant recipients: current status, known challenges, and future strategies. Biol Blood Marrow Transpl. 2003;9:543–58. https://doi.org/10.1016/s1083-8791(03)00287-8 .
doi: 10.1016/s1083-8791(03)00287-8
Symons HJ, Zahurak M, Cao Y, Chen A, Cooke K, Gamper C, et al. Myeloablative haploidentical BMT with posttransplant cyclophosphamide for hematologic malignancies in children and adults. Blood Adv. 2020;4:3913–25. https://doi.org/10.1182/bloodadvances.2020001648 .
doi: 10.1182/bloodadvances.2020001648 pubmed: 32813874 pmcid: 7448587
Srour SA, Milton DR, Bashey A, Karduss-Urueta A, Al Malki MM, Romee R, et al. Haploidentical transplantation with post-transplantation cyclophosphamide for high-risk acute lymphoblastic leukemia. Biol Blood Marrow Transpl. 2017;23:318–24. https://doi.org/10.1016/j.bbmt.2016.11.008 .
doi: 10.1016/j.bbmt.2016.11.008
Solh M, Zhang X, Connor K, Brown S, Solomon SR, Morris LE, et al. Factors predicting graft-versus-host disease-free, relapse-free survival after allogeneic hematopoietic cell transplantation: multivariable analysis from a single center. Biol Blood Marrow Transpl. 2016;22:1403–9. https://doi.org/10.1016/j.bbmt.2016.04.006 .
doi: 10.1016/j.bbmt.2016.04.006
Kröger N, Solano C, Wolschke C, Bandini G, Patriarca F, Pini M, et al. Antilymphocyte globulin for prevention of chronic graft-versus-host disease. N Engl J Med. 2016;374:43–53. https://doi.org/10.1056/NEJMoa1506002 .
doi: 10.1056/NEJMoa1506002 pubmed: 26735993

Auteurs

Wolfgang A Bethge (WA)

Department of Hematology, Oncology, Clinical Immunology and Rheumatology, Center for Internal Medicine, University Hospital Tuebingen, Tuebingen, Germany. wolfgang.bethge@med.uni-tuebingen.de.

Matthias Eyrich (M)

University Children's Hospital Wuerzburg, Wuerzburg, Germany.

Stephan Mielke (S)

Karolinska Institutet and University Hospital, Department of Laboratory Medicine and Department of Medicine Huddinge, CAST, Karolinska Comprehensive Cancer Center, Stockholm, Sweden.
Department of Internal Medicine II, Wuerzburg University Medical Center, Wuerzburg, Germany.

Roland Meisel (R)

Division of Pediatric Stem Cell Therapy, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.

Dietger Niederwieser (D)

University Leipzig, Leipzig, Germany.

Paul G Schlegel (PG)

University Children's Hospital Wuerzburg, Wuerzburg, Germany.

Ansgar Schulz (A)

Department of Pediatrics, University Medical Center Ulm, Ulm, Germany.

Johann Greil (J)

University Children's Hospital Heidelberg, Heidelberg, Germany.

Donald Bunjes (D)

Department of Internal Medicine III, University of Ulm, Ulm, Germany.

Arne Brecht (A)

KMT-Abteilung, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany.

Jurgen Kuball (J)

Department of Haematology and Center for Translational Immunology, University Medical Centre, Utrecht, The Netherlands.

Michael Schumm (M)

CureVac RE GmbH, Tuebingen, Germany.
Department of Hematology/Oncology, University Children's Hospital Tuebingen, Tuebingen, Germany.

Vladan Vucinic (V)

University Leipzig, Leipzig, Germany.

Markus Wiesneth (M)

Institute of Transfusion Medicine, University of Ulm, Ulm, Germany.

Halvard Bonig (H)

Institute for Transfusion Medicine and Immunohematology, and German Red Cross Blood Service BaWüHe, Goethe University, Frankfurt, Germany.

Kasper Westinga (K)

Cell Therapy Facility, University Medical Center Utrecht, Utrecht, The Netherlands.

Stefanie Biedermann (S)

Miltenyi Biotec, Bergisch Gladbach, Germany.

Silke Holtkamp (S)

Miltenyi Biomedicine, Bergisch Gladbach, Germany.

Sandra Karitzky (S)

Miltenyi Biomedicine, Bergisch Gladbach, Germany.

Michaela Malchow (M)

Miltenyi Biomedicine, Bergisch Gladbach, Germany.

Christiane Siewert (C)

Miltenyi Biotec, Bergisch Gladbach, Germany.

Rupert Handgretinger (R)

Department of Hematology/Oncology, University Children's Hospital Tuebingen, Tuebingen, Germany.

Peter Lang (P)

Department of Hematology/Oncology, University Children's Hospital Tuebingen, Tuebingen, Germany. peter.lang@med.uni-tuebingen.de.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH