Murine pre-B-cell ALL induces T-cell dysfunction not fully reversed by introduction of a chimeric antigen receptor

Blood. 2018 Nov 1;132(18):1899-1910. doi: 10.1182/blood-2017-12-815548. Epub 2018 Sep 12.

Abstract

Adoptive transfer of patient-derived T cells modified to express chimeric antigen receptors (CARTs) has demonstrated dramatic success in relapsed/refractory pre-B-cell acute lymphoblastic leukemia (ALL), but response and durability of remission requires exponential CART expansion and persistence. Tumors are known to affect T-cell function, but this has not been well studied in ALL and in the context of chimeric antigen receptor (CAR) expression. Using TCF3/PBX1 and MLL-AF4-driven murine ALL models, we assessed the impact of progressive ALL on T-cell function in vivo. Vaccines protect against TCF3/PBX1.3 but were ineffective when administered after leukemia injection, suggesting immunosuppression induced early during ALL progression. T cells from leukemia-bearing mice exhibited increased expression of inhibitory receptors, including PD1, Tim3, and LAG3, and were dysfunctional following adoptive transfer in a model of T-cell receptor (TCR)-dependent leukemia clearance. Although expression of inhibitory receptors has been linked to TCR signaling, pre-B-cell ALL induced inhibitory receptor expression, at least in part, in a TCR-independent manner. Finally, introduction of a CAR into T cells generated from leukemia-bearing mice failed to fully reverse poor in vivo function.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adoptive Transfer / methods
  • Animals
  • Cancer Vaccines / therapeutic use
  • Disease Models, Animal
  • Disease Progression
  • Female
  • Humans
  • Mice, Inbred C57BL
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Precursor Cells, B-Lymphoid / pathology*
  • Receptors, Chimeric Antigen / analysis
  • T-Lymphocytes / pathology*

Substances

  • Cancer Vaccines
  • Receptors, Chimeric Antigen