Effector memory CD4+ T cells mediate graft-versus-leukemia without inducing graft-versus-host disease |
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Authors: | Zheng Hong Matte-Martone Catherine Li Hongmei Anderson Britt E Venketesan Srividhya Sheng Tan Hung Jain Dhanpat McNiff Jennifer Shlomchik Warren D |
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Institution: | Penn State Milton S. Hershey Medical Center, Department of Medicine, Hershey, PA, USA. |
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Abstract: | Much of the efficacy of allogeneic hematopoietic stem cell transplantation (alloSCT) in curing hematologic malignancies is due to a graft-versus-leukemia (GVL) effect mediated by donor T cells that recognize recipient alloantigens on leukemic cells. Donor T cells are also important for reconstituting immunity in the recipient. Unfortunately, donor T cells can attack nonmalignant host tissues and cause graft-versus-host disease (GVHD). We previously reported that donor CD4(+) effector memory T cells (T(EMs)) do not cause GVHD but transfer functional T-cell memory. In the present work, we demonstrate in an MHC-mismatched model that CD4(+) T(EMs) (unprimed to recipient antigens) mediate GVL against clinically relevant mouse models of chronic phase and blast crisis chronic myelogenous leukemia, without causing GVHD. By creating gene-deficient leukemias and using perforin-deficient T cells, we demonstrate that direct cytolytic function is essential for T(EM)-mediated GVL, but that GVL is retained when killing via FasL, TNF-alpha, TRAIL, and perforin is individually impaired. However, T(EM)-mediated GVL was diminished when both FasL and perforin pathways were blocked. Taken together, our studies identify T(EMs) as a clinically applicable cell therapy for promoting GVL and immune reconstitution, particularly in MHC-mismatched haploidentical alloSCTs in which T cell-depleted allografts are commonly used to minimize GVHD. |
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