Suicide-gene-transduced donor T-cells for controlled graft-versus-host disease and graft-versus-tumor

Fabio Ciceri, Claudio Bordignon

Research output: Contribution to journalArticlepeer-review

Abstract

In allogeneic hematopoietic cell transplantation, donor lymphocytes play a central therapeutic role in both graft-versus-leukemia and immune reconstitution. However, their use is limited by the risk of severe graft-versus-host disease (GVHD). Different strategies have been investigated to obtain all the benefits derived from donor lymphocytes while avoiding the risk of GVHD. Infusions of donor lymphocytes transduced with the herpes simplex virus thymidine kinase (HSV-tk) suicide gene resulted in anti-tumor activity in a substantial number of patients. Acute GVHD could be effectively controlled by ganciclovir-induced elimination of the transduced cells. Haplo-identical stem cell transplantation (haplo-SCT) is a promising therapeutic option for patients with high-risk hematologic malignancies lacking an HLA-matched donor. However, the intensive T-cell depletion required to overcome the risk of lethal GVHD has been associated with a delayed immune recovery with a prolonged risk of posttransplantation viral, fungal, and other opportunistic infections. Donor lymphocyte infusions of HSV-tk represent a promising tool for preventing disease relapse and promoting immune reconstitution after haplo-SCT, and a unique tool for the control of GVHD. The genetic manipulation of donor lymphocytes with a suicide gene is a promising strategy to increase feasibility and safety of allogeneic bone marrow transplantation.

Original languageEnglish
Pages (from-to)305-309
Number of pages5
JournalInternational Journal of Hematology
Volume76
Issue number4
DOIs
Publication statusPublished - Nov 2002

Keywords

  • Gene therapy
  • Graft-versus-tumor
  • Hematopoietic cell transplantation
  • Suicide gene

ASJC Scopus subject areas

  • Hematology

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