1. Over-expression of PD-1 Does Not Predict Leukemic Relapse after Allogeneic Stem Cell Transplantation.
- Author
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Jain P, Tian X, Cordes S, Chen J, Cantilena CR, Bradley C, Panjwani R, Chinian F, Keyvanfar K, Battiwalla M, Muranski P, Barrett AJ, and Ito S
- Subjects
- Adult, Allografts, Disease-Free Survival, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Survival Rate, Biomarkers, Tumor immunology, Gene Expression Regulation, Leukemic immunology, Leukemia immunology, Leukemia mortality, Leukemia pathology, Leukemia therapy, Neoplasm Proteins immunology, Programmed Cell Death 1 Receptor immunology, Stem Cell Transplantation
- Abstract
Blockade of the T-cell exhaustion marker PD-1 to re-energize the immune response is emerging as a promising cancer treatment. Relapse of hematologic malignancy after allogeneic stem cell transplantation limits the success of this approach, and PD-1 blockade may hold therapeutic promise. However, PD-1 expression and its relationship with post-transplant relapse is poorly described. Because the donor immunity is activated by alloresponses, PD-1 expression may differ from nontransplanted individuals, and PD-1 blockade could risk graft-versus-host disease. Here we analyzed T-cell exhaustion marker kinetics and their relationship with leukemia relapse in 85 patients undergoing myeloablative T-cell-depleted HLA-matched stem cell transplantation. At a median follow-up of 3.5 years, 35 (44%) patients relapsed. PD-1 expression in CD4 and CD8 T cells was comparably elevated in relapsed and nonrelapsed cohorts. Helios
+ regulatory T cells and CD8 effector memory cells at day 30 emerged as independent predictors of relapse. Although leukemia antigen-specific T cells did not overexpress PD-1, single-cell analysis revealed LAG3 and TIM3 overexpression at relapse. These findings indicate that PD-1 is an unreliable marker for leukemia-specific T-cell exhaustion in relapsing patients but implies other exhaustion markers and suppressor cells as relapse biomarkers., (Copyright © 2018. Published by Elsevier Inc.)- Published
- 2019
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