Hematopoietic stem cell transplantation in its 60s: A platform for cellular therapies

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Science Translational Medicine  11 Apr 2018:
Vol. 10, Issue 436, eaap9630
DOI: 10.1126/scitranslmed.aap9630
  • Fig. 1 HSCT: A platform for cellular therapies.

    The major biological determinants of clinical outcome after HSCT are the ability of HSCs to regenerate the host hematopoietic system and the immunological events associated with the procedure in the case of allogeneic donors: the beneficial effects of graft-versus-leukemia (GVL) and graft-versus-infection (GVI) and the detrimental effects of GVHD and rejection. Cellular therapy approaches relying on the regenerative capacity of stem cells have also stemmed from HSCT in recent years and have been tested in clinical trials to treat congenital and acquired diseases. In addition, specific cell-based immunotherapy approaches have been designed to boost graft-versus-tumor (GVT) and GVI and to promote immunological tolerance, thus controlling both GVHD and graft rejection. NK, natural killer cells; NKT, natural killer T cells.

    Credit: A. Kitterman/Science Translational Medicine
  • Fig. 2 From HSCT to cellular therapy.

    Timelines summarizing the milestones in the history of HSCT that led to the development of cellular therapy and in particular to HSC gene therapy (A), to cellular therapy approaches able to promote IR after HSCT (B), and to cancer immunotherapy (C). Clinical HSCT milestones have a gray background if they are related to the donor source, and a white background and an oval shape if they are related to conditioning regimens. Milestones relating to advances in biotechnology and cellular therapy are highlighted with a black border, whereas milestones in gene therapy are highlighted with a gray border. RV, retroviral vectors; LV, lentiviral vectors; SCID-Xl, X-linked severe combined immune deficiency; CGD, chronic granulomatous disease; WAS, Wiskott-Aldrich syndrome; β-thal, β-thalassemia; MLD, metachromatic leukodystrophy; x-ALD, x-linked adrenoleukodystrophy; G-CSF, granulocyte colony-stimulating factor; UCBT, umbilical cord blood transplantation; MUD, matched unrelated donor.

    Credit: A. Kitterman/Science Translational Medicine
  • Fig. 3 Targets of T cells mediating GVT in cellular therapy.

    Control of malignant disease by self-HLA–restricted T cells can be targeted to tumor-specific antigens (TSAs; red), mHAgs (blue), or mismatched HLA molecules (pink). TSA-specific T cells are the only ones that are potentially present not only in the allogeneic but also in the autologous context. mHAgs are the only alloantigens in related sibling donors, whereas both mHAgs and mismatched HLA (mainly HLA-DP) can be recognized by unrelated or mismatched related donor T cells. TSA- and mHAg-specific T cells are found mainly in the naïve compartment and have a low precursor frequency, whereas alloreactive T cells against mismatched HLA occur both in the naïve and in the memory compartment and have a higher precursor frequency. APC, antigen-presenting cell. Autologous patient cells are depicted in gray, and donor T cells are depicted in blue.

    Credit: A. Kitterman/Science Translational Medicine
  • Fig. 4 T cell therapy in the era of precision medicine.

    Increased complexity in manufacturing costs and regulatory issues arise together with improved potency, specificity, and safety of cellular therapy products in the era of personalized precision medicine. The figure indicates the degree of precision (y axis) versus complexity (x axis) for different cellular therapy approaches.

    Credit: A. Kitterman/Science Translational Medicine

Supplementary Materials

  • Supplementary Material for:

    Hematopoietic stem cell transplantation in its 60s: A platform for cellular therapies

    Christian Chabannon,* Jurgen Kuball, Attilio Bondanza, Francesco Dazzi, Paolo Pedrazzoli, Antoine Toubert, Annalisa Ruggeri, Katharina Fleischhauer, Chiara Bonini*

    *Corresponding author. Email: bonini.chiara{at} (C.B.); chabannonc{at} (C.C.)

    Published 11 April 2018, Sci. Transl. Med. 10, eaap9630 (2018)
    DOI: 10.1126/scitranslmed.aap9630

    This PDF file includes:

    • Table S1. A non-exhaustive list of somatic cell therapy and gene therapy medicinal products authorized by the FDA or EMA.

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