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Prepublished online as a Blood First Edition Paper on October 3, 2002; DOI 10.1182/blood-2002-08-2351.

Submitted August 13, 2002
Accepted September 24, 2002
Immunologic potential of donor lymphocytes expressing a suicide gene for early immune reconstitution after hematopoietic T cell-depleted stem cell transplantation
Sarah Marktel, Zulma Magnani, Fabio Ciceri, Sabrina Cazzaniga, Stanley R Riddell, Catia Traversari, Claudio Bordignon, and Chiara Bonini*
Cancer Immunotherapy and Gene Therapy Program, Istituto Scientifico H.S. Raffaele, Milan, Italy; Bone Marrow Transplantation Unit, Istituto Scientifico H.S. Raffaele, Milan, Italy
Cancer Immunotherapy and Gene Therapy Program, Istituto Scientifico H.S. Raffaele, Milan, Italy
Bone Marrow Transplantation Unit, Istituto Scientifico H.S. Raffaele, Milan, Italy; Cancer Immunotherapy and Gene Therapy Program, Istituto Scientifico H.S. Raffaele, Milan, Italy
Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, USA
Molmed S.p.A., Milan, Italy
* Corresponding author; email: chiara.bonini{at}hsr.it.
We have previously shown that the infusion of donor lymphocytes expressing the HSV thymidine kinase (HSV-tk) gene is an efficient tool for controlling graft-versus-host disease (GvHD), while preserving graft-versus-leukemia (GvL). In addition to the GvL effect, administration of donor HSV-tk+ cells could have a clinical impact in promoting immune reconstitution after T cell depleted stem cell transplantation (SCT). To explore this hypothesis, we have investigated whether in vitro polyclonal activation, retroviral transduction, immunoselection and expansion affect the immune competence of donor T cells. We have observed that, after appropriate in vitro manipulation, T cells specific for antigens relevant in the context of SCT are preserved in terms of frequency, expression of T cell receptor, proliferation, cytokine secretion and lytic activity. A reduction in the frequency of allo-specific T cell precursors was observed after prolonged T cell culture, suggesting that cell manipulation protocols involving a short culture time and high transduction efficiency are needed. Finally, the long term persistence of HSV-tk+ cells was observed in a patient treated in the GvL clinical trial, and a reversion of the phenotype of HSV-tk+ cells from CD45RO+ to CD45RA+ was documented more than 2 years after the infusion. Based on all these evidences, we propose a clinical study of preemptive infusions of donor HSV-tk+ T cells after SCT from haplo-identical donors, to provide early immune reconstitution against infections and potential immune protection against disease recurrence.

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