[HTML][HTML] Flt3L treatment of bone marrow donors increases graft plasmacytoid dendritic cell content and improves allogeneic transplantation outcomes

M Hassan, AU Antonova, JM Li, S Hosoba… - Biology of Blood and …, 2019 - Elsevier
M Hassan, AU Antonova, JM Li, S Hosoba, M Rupji, J Kowalski, AJ Perricone, DL Jaye
Biology of Blood and Marrow Transplantation, 2019Elsevier
ABSTRACT A higher number of donor plasmacytoid dendritic cells (pDCs) is associated with
increased survival and reduced graft-versus-host disease (GVHD) in human recipients of
unrelated donor bone marrow (BM) grafts, but not granulocyte colony-stimulating factor (G-
CSF)-mobilized peripheral blood grafts. We show that in murine models, donor BM pDCs
are associated with increased survival and decreased GVHD compared with G-CSF-
mobilized pDCs. To increase the content of pDCs in BM grafts, we studied the effect of FMS …
Abstract
A higher number of donor plasmacytoid dendritic cells (pDCs) is associated with increased survival and reduced graft-versus-host disease (GVHD) in human recipients of unrelated donor bone marrow (BM) grafts, but not granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood grafts. We show that in murine models, donor BM pDCs are associated with increased survival and decreased GVHD compared with G-CSF-mobilized pDCs. To increase the content of pDCs in BM grafts, we studied the effect of FMS-like tyrosine kinase 3 ligand (Flt3L) treatment of murine BM donors on transplantation outcomes. Flt3L treatment (300 μg/kg/day) resulted in a schedule-dependent increase in the content of pDCs in the BM. Mice treated on days -4 and -1 had a >5-fold increase in pDC content without significant changes in numbers of HSCs, T cells, B cells, and natural killer cells in the BM graft. In an MHC-mismatched murine transplant model, recipients of Flt3L-treated T cell-depleted (TCD) BM (TCD F-BM) and cytokine-untreated T cells had increased survival and decreased GVHD scores with fewer Th1 and Th17 polarized T cells post-transplantation compared with recipients of equivalent numbers of untreated donor TCD BM and T cells. Gene array analyses of pDCs from Flt3L-treated human and murine donors showed up-regulation of adaptive immune pathways and immunoregulatory checkpoints compared with pDCs from untreated BM donors. Transplantation of TCD F-BM plus T cells resulted in no loss of the graft-versus-leukemia (GVL) effect compared with grafts from untreated donors in 2 murine GVL models. Thus, Flt3L treatment of BM donors is a novel method for increasing the pDC content in allografts, improving survival, and decreasing GVHD without diminishing the GVL effect.
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