A blood dendritic cell vaccine for acute myeloid leukemia expands anti-tumor T cell responses at remission

Jennifer L. Hsu, Christian E. Bryant, Michael S. Papadimitrious, Benjamin Kong, Robin E. Gasiorowski, Daniel Orellana, Helen M. McGuire, Barbara Fazekas de St Groth, Douglas E. Joshua, P. Joy Ho, Stephen Larsen, Harry J. Iland, John Gibson, Georgina J. Clark, Phillip D. Fromm, Derek N. J. Hart

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Only modest advances in AML therapy have occurred in the past decade and relapse due to residual disease remains the major challenge. The potential of the immune system to address this is evident in the success of allogeneic transplantation, however this leads to considerable morbidity. Dendritic cell (DC) vaccination can generate leukemia-specific autologous immunity with little toxicity. Promising results have been achieved with vaccines developed in vitro from purified monocytes (Mo-DC). We now demonstrate that blood DC (BDC) have superior function to Mo-DC. Whilst BDC are reduced at diagnosis in AML, they recover following chemotherapy and allogeneic transplantation, can be purified using CMRF-56 antibody technology, and can stimulate functional T cell responses. While most AML patients in remission had a relatively normal T cell landscape, those who had received fludarabine as salvage therapy have persistent T cell abnormalities including reduced number, altered subset distribution, failure to expand, and increased activation-induced cell death. Furthermore, PD-1 and TIM-3 are increased on CD4T cells in AML patients in remission and their blockade enhances the expansion of leukemia-specific T cells. This confirms the feasibility of a BDC vaccine to consolidate remission in AML and suggests it should be tested in conjunction with checkpoint blockade.
Original languageEnglish
Article numbere1419114
Pages (from-to)1-11
Number of pages11
JournalOncoImmunology
Volume7
Issue number4
DOIs
Publication statusPublished - 3 Apr 2018
Externally publishedYes

Keywords

  • Acute Myeloid Leukemia
  • Allogeneic Haematopoietic Stem Cell Transplantation
  • Blood Dendritic Cell
  • Checkpoint Inhibitor
  • Chemotherapy
  • Immunotherapy
  • T Cell Landscape

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