Post-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells

Immune checkpoint inhibitors (CI) have demonstrated clinical activity in Hodgkin Lymphoma (HL) patients relapsing after autologous stem cell transplantation (ASCT), although only 20% complete response (CR) rate was observed. The efficacy of CI is strictly related to the host immune competence, which...

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Autores principales: Fabio Guolo, Paola Minetto, Silvia Pesce, Filippo Ballerini, Marino Clavio, Michele Cea, Michela Frello, Matteo Garibotto, Marco Greppi, Matteo Bozzo, Maurizio Miglino, Monica Passannante, Riccardo Marcolin, Elisabetta Tedone, Nicoletta Colombo, Rosa Mangerini, Alessandra Bo, Maria Rosaria Ruzzenenti, Paolo Carlier, Alberto Serio, Silvia Luchetti, Alida Dominietto, Riccardo Varaldo, Simona Candiani, Vanessa Agostini, Jean Louis Ravetti, Genny Del Zotto, Emanuela Marcenaro, Roberto Massimo Lemoli
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Publicado: Frontiers Media S.A. 2021
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Acceso en línea:https://doaj.org/article/8a2f7160a3604c7ab74567cee42b953c
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spelling oai:doaj.org-article:8a2f7160a3604c7ab74567cee42b953c2021-11-05T15:20:50ZPost-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells1664-322410.3389/fimmu.2021.753890https://doaj.org/article/8a2f7160a3604c7ab74567cee42b953c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.753890/fullhttps://doaj.org/toc/1664-3224Immune checkpoint inhibitors (CI) have demonstrated clinical activity in Hodgkin Lymphoma (HL) patients relapsing after autologous stem cell transplantation (ASCT), although only 20% complete response (CR) rate was observed. The efficacy of CI is strictly related to the host immune competence, which is impaired in heavily pre-treated HL patients. Here, we aimed to enhance the activity of early post-ASCT CI (nivolumab) administration with the infusion of autologous lymphocytes (ALI). Twelve patients with relapse/refractory (R/R) HL (median age 28.5 years; range 18-65), underwent lymphocyte apheresis after first line chemotherapy and then proceeded to salvage therapy. Subsequently, 9 patients with progressive disease at ASCT received early post-transplant CI supported with four ALI, whereas 3 responding patients received ALI alone, as a control cohort. No severe adverse events were recorded. HL-treated patients achieved negative PET scan CR and 8 are alive and disease-free after a median follow-up of 28 months. Four patients underwent subsequent allogeneic SCT. Phenotypic analysis of circulating cells showed a faster expansion of highly differentiated NK cells in ALI plus nivolumab-treated patients as compared to control patients. Our data show anti-tumor activity with good tolerability of ALI + CI for R/R HL and suggest that this setting may accelerate NK cell development/maturation and favor the expansion of the “adaptive” NK cell compartment in patients with HCMV seropositivity, in the absence of HCMV reactivation.Fabio GuoloFabio GuoloPaola MinettoSilvia PesceFilippo BalleriniMarino ClavioMichele CeaMichele CeaMichela FrelloMatteo GaribottoMarco GreppiMatteo BozzoMatteo BozzoMaurizio MiglinoMaurizio MiglinoMonica PassannanteRiccardo MarcolinElisabetta TedoneNicoletta ColomboRosa MangeriniAlessandra BoMaria Rosaria RuzzenentiPaolo CarlierAlberto SerioSilvia LuchettiAlida DominiettoRiccardo VaraldoSimona CandianiVanessa AgostiniJean Louis RavettiGenny Del ZottoEmanuela MarcenaroRoberto Massimo LemoliRoberto Massimo LemoliFrontiers Media S.A.articleHodgkin lymphomanivolumabnatural killer cellsprogrammed cell death receptor 1NK cell maturationimmune check pointImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution DOAJ
collection DOAJ
language EN
topic Hodgkin lymphoma
nivolumab
natural killer cells
programmed cell death receptor 1
NK cell maturation
immune check point
Immunologic diseases. Allergy
RC581-607
spellingShingle Hodgkin lymphoma
nivolumab
natural killer cells
programmed cell death receptor 1
NK cell maturation
immune check point
Immunologic diseases. Allergy
RC581-607
Fabio Guolo
Fabio Guolo
Paola Minetto
Silvia Pesce
Filippo Ballerini
Marino Clavio
Michele Cea
Michele Cea
Michela Frello
Matteo Garibotto
Marco Greppi
Matteo Bozzo
Matteo Bozzo
Maurizio Miglino
Maurizio Miglino
Monica Passannante
Riccardo Marcolin
Elisabetta Tedone
Nicoletta Colombo
Rosa Mangerini
Alessandra Bo
Maria Rosaria Ruzzenenti
Paolo Carlier
Alberto Serio
Silvia Luchetti
Alida Dominietto
Riccardo Varaldo
Simona Candiani
Vanessa Agostini
Jean Louis Ravetti
Genny Del Zotto
Emanuela Marcenaro
Roberto Massimo Lemoli
Roberto Massimo Lemoli
Post-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells
description Immune checkpoint inhibitors (CI) have demonstrated clinical activity in Hodgkin Lymphoma (HL) patients relapsing after autologous stem cell transplantation (ASCT), although only 20% complete response (CR) rate was observed. The efficacy of CI is strictly related to the host immune competence, which is impaired in heavily pre-treated HL patients. Here, we aimed to enhance the activity of early post-ASCT CI (nivolumab) administration with the infusion of autologous lymphocytes (ALI). Twelve patients with relapse/refractory (R/R) HL (median age 28.5 years; range 18-65), underwent lymphocyte apheresis after first line chemotherapy and then proceeded to salvage therapy. Subsequently, 9 patients with progressive disease at ASCT received early post-transplant CI supported with four ALI, whereas 3 responding patients received ALI alone, as a control cohort. No severe adverse events were recorded. HL-treated patients achieved negative PET scan CR and 8 are alive and disease-free after a median follow-up of 28 months. Four patients underwent subsequent allogeneic SCT. Phenotypic analysis of circulating cells showed a faster expansion of highly differentiated NK cells in ALI plus nivolumab-treated patients as compared to control patients. Our data show anti-tumor activity with good tolerability of ALI + CI for R/R HL and suggest that this setting may accelerate NK cell development/maturation and favor the expansion of the “adaptive” NK cell compartment in patients with HCMV seropositivity, in the absence of HCMV reactivation.
format article
author Fabio Guolo
Fabio Guolo
Paola Minetto
Silvia Pesce
Filippo Ballerini
Marino Clavio
Michele Cea
Michele Cea
Michela Frello
Matteo Garibotto
Marco Greppi
Matteo Bozzo
Matteo Bozzo
Maurizio Miglino
Maurizio Miglino
Monica Passannante
Riccardo Marcolin
Elisabetta Tedone
Nicoletta Colombo
Rosa Mangerini
Alessandra Bo
Maria Rosaria Ruzzenenti
Paolo Carlier
Alberto Serio
Silvia Luchetti
Alida Dominietto
Riccardo Varaldo
Simona Candiani
Vanessa Agostini
Jean Louis Ravetti
Genny Del Zotto
Emanuela Marcenaro
Roberto Massimo Lemoli
Roberto Massimo Lemoli
author_facet Fabio Guolo
Fabio Guolo
Paola Minetto
Silvia Pesce
Filippo Ballerini
Marino Clavio
Michele Cea
Michele Cea
Michela Frello
Matteo Garibotto
Marco Greppi
Matteo Bozzo
Matteo Bozzo
Maurizio Miglino
Maurizio Miglino
Monica Passannante
Riccardo Marcolin
Elisabetta Tedone
Nicoletta Colombo
Rosa Mangerini
Alessandra Bo
Maria Rosaria Ruzzenenti
Paolo Carlier
Alberto Serio
Silvia Luchetti
Alida Dominietto
Riccardo Varaldo
Simona Candiani
Vanessa Agostini
Jean Louis Ravetti
Genny Del Zotto
Emanuela Marcenaro
Roberto Massimo Lemoli
Roberto Massimo Lemoli
author_sort Fabio Guolo
title Post-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells
title_short Post-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells
title_full Post-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells
title_fullStr Post-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells
title_full_unstemmed Post-Transplant Nivolumab Plus Unselected Autologous Lymphocytes in Refractory Hodgkin Lymphoma: A Feasible and Promising Salvage Therapy Associated With Expansion and Maturation of NK Cells
title_sort post-transplant nivolumab plus unselected autologous lymphocytes in refractory hodgkin lymphoma: a feasible and promising salvage therapy associated with expansion and maturation of nk cells
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/8a2f7160a3604c7ab74567cee42b953c
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