In the major histocompatibility complex (MHC)-matched hematopoietic cell transplantation (HCT) setting, minor histocompatibility antigens (miHAs) are implicated in curative graft-versus-tumor (GVT) responses for patients with hematologic malignancies, as well as the morbidity of graft rejection and graft-versus-host disease (GVHD). Minor histocompatibility antigens are MHC class I- and class II-presented endogenous peptides derived from nonsynonymous disparities within coding regions between the donor and recipient. These include unique Y chromosome disparities (H-Y) in female into male HCT. Genetic disparities that give rise to miHAs including H-Y are only antigenic when presented in the context of specific MHC molecules, a requirement termed HLA-restricted and dog leukocyte antigen (DLA)-restricted, in humans and dogs, respectively. Tissue-selective expression of miHAs suggests that it may be possible to augment and separate GVT responses from GVHD using a miHA vaccine.1 Although some miHAs are known in humans, formidable obstacles of efficacy, safety, and feasibility currently prevent the translation of our knowledge of miHAs into an established immunotherapy.2 We seek to establish a recombinant miHA vaccine in the canine model of allogeneic HCT to provide a large outbred animal model capable of addressing the challenges faced in implementing a miHA vaccine in human allogeneic HCT. With minimum-intensity conditioning, DLA-identical marrow infusion, and a short course of postgrafting immunosuppression, the canine model produces stable mixed donor-recipient hematopoietic chimeras.3 This mixed chimerism is a state of tolerance between donor and recipient cells and is not affected by “unsensitized” donor lymphocyte infusions (DLIs).4,5 However, if the donor is first sensitized to miHAs via recipient-derived skin implants, organ transplantation, or injections of allogeneic peripheral blood mononuclear cells (PBMCs), then a sensitized DLI breaks tolerance resulting in full donor chimerism that is often accompanied by GVHD.4-7 Thus, stable mixed chimerism provides a reproducible in vivo model to test donor T cell sensitization against recipient miHAs. A graphic reproduction of published results on chimerism analyses after unsensitized and miHA-sensitized DLI into DLA-identical mixed chimeras is provided in Figure Figure11 as a reference to interpret the results of this pilot study.4 FIGURE 1 Reproduction of published results following unsensitized DLI and miHA-sensitized DLI into eight stable mixed chimeric recipients.4 The chimerism results were shown as percent donor PBMC on the y axis, with weeks after the DLI shown on the x axis. Eight ... A major challenge facing the development of a recombinant miHA vaccine in the canine model is the lack of characterized miHAs. T cell cloning reagents used to characterize miHAs in humans are not yet available in the canine model. Instead, we postulated that making a vaccine encoding large sections of Y chromosome gene disparities may overcome the lack of peptide-level characterization of miHAs in the canine model and allow us to further develop this model through the use of female transplant donors and male transplant recipients. At the time of vaccine development, the canine genome had only 3 Y chromosome gene sequences available including ubiquitously transcribed tetratricopeptide repeat containing, Y-linked (UTY), selected mouse CDNA on Y (SMCY), and sex determining region Y (SRY). Attempts were made to clone the most disparate sections with respect to their X homologues of the large genes UTY and SMCY, as well as the entire small SRY gene. After 2 cloning attempts, 3 domains of canine SMCY encoding approximately 60% of the total disparities with the X-homologue SMCX were cloned, as well as the entire SRY gene. These clones were shuttled into DNA expression plasmids and replication-deficient human adenovirus type 5 (rAd5) vectors. Three female HCT donors then received 2 doses of the expression plasmids delivered by particle-mediated epidermal delivery (PMED) 4 weeks apart, and then 4 weeks later received an intramuscular boost of rAd5. Four weeks after the rAd5 boost injection, a DLI into their respective male mixed hematopoietic chimeric recipients resulted in a significant increase in donor chimerism in 1 of 3 hosts, representing the first functional miHA response to a recombinant miHA vaccine in a large animal model.8 In our initial vaccine series, we observed relatively weak antigen-specific T cell responses at the time of the first DLI. We hypothesized that “inadequate donor sensitization” may explain why the observed increase in donor chimerism did not reach full donor chimerism and explain the lack of change in donor chimerism in the other 2 recipients. Because 2 of the original donor-recipient transplant pairs were still available, including the pair whose recipient demonstrated an increase in donor chimerism after the first DLI, we were able to address this hypothesis with 4 additional PMED boost injections in the 2 female donors followed by a second DLI into their respective male mixed hematopoietic chimeric recipients.