Summary:In chronic myeloid leukemia (CML) ex vivo generated DC are characterized by constitutive expression of bcr/abl and possibly other yet undefined leukemia-associated antigens, since these DC share a common progeny with leukemic cells. Induction of anti-leukemic T cell responses has been described in vitro. For a phase I vaccination study, autologous bcr/abl؉ DC are generated under GMP conditions mainly from monocyte precursors in chronic phase CML patients. Lin Induction of T cell immunity against leukemic cells by dendritic cells (DC) has been demonstrated in vitro both in chronic myeloid leukemia (CML) and in acute myeloid leukemia (AML).1-3 Chimeric fusion proteins resulting from chromosomal translocations can be considered as ideal target molecules for cytotoxic T cell responses, since these molecules are restricted to the malignant cell clone. In CML Ͼ90% of the patients express the 210 kDa chimeric fusion proteins bcr2/abl2 or bcr3/abl2. Both fusion proteins possess abnormal tyrosine kinase activity and play a key role in the pathogenesis of the disease. Within the fusion region of the bcr3/abl2 protein, different peptides have been identified which bind to HLA-A2, -A3, -A11 and -B8. 3,5-7 Furthermore, several HLA class II binding peptides have been isolated from the bcr/abl fusion region. Since DC can be generated in vitro from bcr/abl-positive precursors -CD34 ϩ cells and monocytes -the resulting DC population is largely bcr/abl-positive. In chronic phase CML, cytotoxic anti-leukemic T cell responses can be elicited by these unmodified DC, 1,8 possibly by constitutive presentation of bcr/ablϪ or other yet unknown peptides.In our GMP laboratory, autologous unmodified DC are generated as vaccine in patients with chronic phase bcr/ablpositive CML.
Materials and methods
Generation of DC for clinical application from monocytes according to GMP criteriaDC were generated from patients with chronic phase bcr/ablϩ CML according to our study protocol which had been approved by the local ethics committee. Peripheral blood mononuclear cells (PBMC) were collected by standard leukapheresis using an AS 104 cell separator (Fresenius, Bad Homburg, Germany). PBMC were further enriched by density gradient centrifugation on Lymphoprep (Life Technologies, Karlsruhe, Germany) and then stored on liquid nitrogen using RPMI 1640 (BioWhittaker, Verviers, Belgium) with 42.5% Human Serum Albumin (HSA, Octapharm) and 10% DMSO (Sigma). Thawing of PBMC was performed by addition of HBSS w/o Caϩϩ/Mgϩϩ (BioWhittaker) containing 5% HSA. PBMC were washed twice and then exposed to plastic adherence for monocyte enrichment. Briefly, PBMC were seeded at a density of 1.4 ϫ 10 6