Hematopoiesis-restricted minor histocompatibility antigens HA-1-or HA-2-specific T cells can induce complete remissions of relapsed leukemia

WAE Marijt, MHM Heemskerk… - Proceedings of the …, 2003 - National Acad Sciences
WAE Marijt, MHM Heemskerk, FM Kloosterboer, E Goulmy, MGD Kester…
Proceedings of the National Academy of Sciences, 2003National Acad Sciences
Donor lymphocyte infusion (DLI) into patients with a relapse of their leukemia or multiple
myeloma after allogeneic stem cell transplantation (alloSCT) has been shown to be a
successful treatment approach. The hematopoiesis-restricted minor histocompatibility
antigens (mHAgs) HA-1 or HA-2 expressed on malignant cells of the recipient may serve as
target antigens for alloreactive donor T cells. Recently we treated three mHAg HA-1-and/or
HA-2-positive patients with a relapse of their disease after alloSCT with DLI from their mHAg …
Donor lymphocyte infusion (DLI) into patients with a relapse of their leukemia or multiple myeloma after allogeneic stem cell transplantation (alloSCT) has been shown to be a successful treatment approach. The hematopoiesis-restricted minor histocompatibility antigens (mHAgs) HA-1 or HA-2 expressed on malignant cells of the recipient may serve as target antigens for alloreactive donor T cells. Recently we treated three mHAg HA-1- and/or HA-2-positive patients with a relapse of their disease after alloSCT with DLI from their mHAg HA-1- and/or HA-2-negative donors. Using HLA-A2/HA-1 and HA-2 peptide tetrameric complexes we showed the emergence of HA-1- and HA-2-specific CD8+ T cells in the blood of the recipients 5–7 weeks after DLI. The appearance of these tetramer-positive cells was followed immediately by a complete remission of the disease and restoration of 100% donor chimerism in each of the patients. Furthermore, cloned tetramer-positive T cells isolated during the clinical response specifically recognized HA-1 and HA-2 expressing malignant progenitor cells of the recipient and inhibited the growth of leukemic precursor cells in vitro. Thus, HA-1- and HA-2-specific cytotoxic T lymphocytes emerging in the blood of patients after DLI demonstrate graft-versus-leukemia or myeloma reactivity resulting in a durable remission. This finding implies that in vitro generated HA-1- and HA-2-specific cytotoxic T lymphocytes could be used as adoptive immunotherapy to treat hematological malignances relapsing after alloSCT.
National Acad Sciences