Inducible caspase 9 suicide gene to improve the safety of allodepleted T cells after haploidentical stem cell transplantation

Biol Blood Marrow Transplant. 2007 Aug;13(8):913-24. doi: 10.1016/j.bbmt.2007.04.005. Epub 2007 May 29.

Abstract

Addback of donor T cells following T cell-depleted stem cell transplantation (SCT) can accelerate immune reconstitution and be effective against relapsed malignancy. After haploidentical SCT, a high risk of graft-versus-host disease (GVHD) essentially precludes this option, unless the T cells are first depleted of alloreactive precursor cells. Even then, the risks of severe GVHD remain significant. To increase the safety of the approach and thereby permit administration of larger T cell doses, we used a suicide gene, inducible caspase 9 (iCasp9), to transduce allodepleted T cells, permitting their destruction should administration have adverse effects. We made a retroviral vector encoding iCasp9 and a selectable marker (truncated CD19). Even after allodepletion (using anti-CD25 immunotoxin), donor T cells could be efficiently transduced, expanded, and subsequently enriched by CD19 immunomagnetic selection to >90% purity. These engineered cells retained antiviral specificity and functionality, and contained a subset with regulatory phenotype and function. Activating iCasp9 with a small-molecule dimerizer rapidly produced >90% apoptosis. Although transgene expression was downregulated in quiescent T cells, iCasp9 remained an efficient suicide gene, as expression was rapidly upregulated in activated (alloreactive) T cells. We have demonstrated the clinical feasibility of this approach after haploidentical transplantation by scaling up production using clinical grade materials.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apoptosis
  • Caspase 9 / genetics*
  • Caspase 9 / metabolism
  • Feasibility Studies
  • Genes, Transgenic, Suicide*
  • Genetic Vectors
  • Graft vs Host Disease / prevention & control*
  • Haplotypes
  • Hematopoietic Stem Cell Transplantation / methods
  • Hematopoietic Stem Cells
  • Humans
  • Immunotherapy, Adoptive / methods
  • Lymphocyte Transfusion / methods*
  • Retroviridae / genetics
  • T-Lymphocytes / classification
  • T-Lymphocytes / transplantation*
  • Transduction, Genetic
  • Transplantation, Homologous

Substances

  • Caspase 9