Inhibition of acute graft-versus-host disease with retention of graft-versus-tumor effects by the proteasome inhibitor bortezomib

Proc Natl Acad Sci U S A. 2004 May 25;101(21):8120-5. doi: 10.1073/pnas.0401563101. Epub 2004 May 17.

Abstract

Graft-versus-host disease (GVHD) represents a major hurdle impeding the efficacy of allogeneic bone marrow transplantation (BMT). Bortezomib is a proteasome inhibitor that was recently approved for treatment of myeloma. We found that bortezomib potently inhibited in vitro mixed lymphocyte responses and promoted the apoptosis of alloreactive T cells. Bortezomib given at the time of allogeneic BMT in mice resulted in significant protection from acute GVHD. Reductions in GVHD-associated parameters and biological evidence of proteasome inhibition were observed with this regimen but with no adverse effects on long-term donor reconstitution. Assessment of graft-versus-tumor responses in advanced leukemia-bearing mice demonstrated that only the combination of allogeneic BMT and T cells with bortezomib promoted significant increases in survival. Increased cytotoxic T cell killing of the tumor was also observed. Thus, the combination of proteasome inhibition with selective immune attack can markedly increase the efficacy of BMT in cancer.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease / therapy
  • Animals
  • Bone Marrow Transplantation / adverse effects
  • Bone Marrow Transplantation / immunology
  • Boronic Acids / adverse effects
  • Boronic Acids / pharmacology*
  • Boronic Acids / therapeutic use
  • Bortezomib
  • Cell Line, Tumor
  • Female
  • Graft vs Host Disease / drug therapy
  • Graft vs Host Disease / immunology*
  • Graft vs Host Disease / prevention & control*
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred C57BL
  • NF-kappa B / metabolism
  • Protease Inhibitors / adverse effects
  • Protease Inhibitors / pharmacology*
  • Protease Inhibitors / therapeutic use
  • Pyrazines / adverse effects
  • Pyrazines / pharmacology*
  • Pyrazines / therapeutic use
  • Survival Analysis
  • T-Lymphocytes, Cytotoxic / cytology
  • T-Lymphocytes, Cytotoxic / drug effects
  • T-Lymphocytes, Cytotoxic / immunology
  • Transplantation, Homologous

Substances

  • Boronic Acids
  • NF-kappa B
  • Protease Inhibitors
  • Pyrazines
  • Bortezomib