Tracking in vivo dynamics of NK cells transferred in patients undergoing stem cell transplantation

Eur J Immunol. 2014 Sep;44(9):2822-34. doi: 10.1002/eji.201444586. Epub 2014 Jun 30.


Haploidentical stem cell transplantation (haploSCT) offers an alternative treatment option for advanced leukemia patients lacking a HLA-compatible donor. Transfer of NK cells represents a promising therapeutic option in combination with SCT, as NK cells can promote graft versus leukemia with low risk of GVH disease. In this study, we show results from a phase I/II trial in which 24 acute myeloid leukemia patients underwent haploSCT in combination with early transfer of unmodified NK cells and observed a promising 2-year overall survival rate of 37%. By performing immunomonitoring and subsequent principal component analysis, we tracked donor NK-cell dynamics in the patients and distinguished between NK cells reconstituting from CD34(+) precursors, giving rise over time to a continuum of multiple differentiation stages, and adoptively transferred NK cells. Transferred NK cells displayed a mature phenotype and proliferated in vivo during the early days after haploSCT even in the absence of exogenous IL-2 administration. Moreover, we identified the NK-cell phenotype associated with in vivo expansion. Thus, our study indicates a promising path for adoptive transfer of unmodified NK cells in the treatment of high-risk acute myeloid leukemia.

Keywords: Acute myeloid leukemia; Hematopoietic stem cell transplantation; NK cells; Principal component analysis.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Agents / pharmacology
  • Cell Proliferation / drug effects
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Interleukin-2 / pharmacology
  • Killer Cells, Natural / immunology*
  • Killer Cells, Natural / pathology
  • Leukemia, Myeloid, Acute* / immunology
  • Leukemia, Myeloid, Acute* / mortality
  • Leukemia, Myeloid, Acute* / therapy
  • Male
  • Middle Aged
  • Phenotype
  • Risk Factors
  • Stem Cell Transplantation*
  • Survival Rate
  • Unrelated Donors*


  • Antineoplastic Agents
  • IL2 protein, human
  • Interleukin-2