Human Effectors of Acute and Chronic GVHD Overexpress CD83 and Predict Mortality

Shernan G. Holtan; Constanza Savid-Frontera; Kelly Walton; Anne A. Eaton; Connor Demorest; Andrea Hoeschen; Ling Zhang; Kayla Reid; Tony Kurian; Zena Sayegh; Estefania Julia; Joseph Maakaron; Veronika Bachanova; Najla El Jurdi; Margaret L. MacMillan; Daniel J. Weisdorf; Martin Felices; Jeffrey S. Miller; Bruce R. Blazar; Marco L. Davila; Brian C. Betts

doi:10.1158/1078-0432.CCR-22-2837

Human Effectors of Acute and Chronic GVHD Overexpress CD83 and Predict Mortality

Shernan G. Holtan, Constanza Savid-Frontera, Kelly Walton, Anne A. Eaton, Connor Demorest, Andrea Hoeschen, Ling Zhang, Kayla Reid, Tony Kurian, Zena Sayegh, Estefania Julia, Joseph Maakaron, Veronika Bachanova, Najla El Jurdi, Margaret L. MacMillan, Daniel J. Weisdorf, Martin Felices, Jeffrey S. Miller, Bruce R. Blazar, Marco L. DavilaBrian C. Betts

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Purpose: Acute and chronic GVHD remain major causes of transplant-related morbidity and mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). We have shown CD83 chimeric antigen receptor (CAR) T cells prevent GVHD and kill myeloid leukemia cell lines. In this pilot study, we investigate CD83 expression on GVHD effector cells, correlate these discoveries with clinical outcomes, and evaluate critical therapeutic implications for transplant recipients. Experimental Design: CD83 expression was evaluated among circulating CD4+ T cells, B-cell subsets, T follicular helper (Tfh) cells, and monocytes from patients with/without acute or chronic GVHD (n = 48 for each group), respectively. CD83 expression was correlated with survival, TRM, and relapse after alloHCT. Differential effects of GVHD therapies on CD83 expression was determined. Results: CD83 overexpression on CD4+ T cells correlates with reduced survival and increased TRM. Increased CD83+ B cells and Tfh cells, but not monocytes, are associated with poor posttransplant survival. CD83 CAR T eliminate autoreactive CD83+ B cells isolated from patients with chronic GVHD, without B-cell aplasia as observed with CD19 CAR T. We demonstrate robust CD83 antigen density on human acute myeloid leukemia (AML), and confirm potent antileukemic activity of CD83 CAR T in vivo, without observed myeloablation. Conclusions: CD83 is a promising diagnostic marker of GVHD and warrants further investigation as a therapeutic target of both GVHD and AML relapse after alloHCT.

Original language	English (US)
Pages (from-to)	1114-1124
Number of pages	11
Journal	Clinical Cancer Research
Volume	29
Issue number	6
DOIs	https://doi.org/10.1158/1078-0432.CCR-22-2837
State	Published - Mar 15 2023

Bibliographical note

Funding Information:
Our study received assistance from the Flow Cytometry Core Facility at the H. Lee Moffitt Cancer Center & Research Institute and the Flow Cytometry Resource at the University of Minnesota, both of which are NCI-designated Comprehensive Cancer Centers. This work was supported by funds from Masonic Cancer Center (BCB), Moffitt Cancer Center (MLD), CCSG grants at Moffitt and the Masonic Cancer Centers, and grant support including NHLBI R01 HL56067, R01 HL 11879, R01 HL 155114, and NIAID R37 AI 34495 (BRB).

Funding Information:
S.G. Holtan reports other support from Incyte and VITRAC Therapeutics outside the submitted work; in addition, S.G. Holtan serves as a clinical trial adjudicator for CSL Behring. A.A. Eaton reports grants from NCI during the conduct of the study, as well as grants from NIH outside the submitted work. J. Maakaron reports other support from Gilead, ADC Therapeutics, CRISPR, and Precision BioSciences outside the submitted work. D.J. Weisdorf reports grants from Fate Therapeutics and Incyte outside the submitted work. M. Felices reports personal fees from GT Biopharma outside the submitted work. J.S. Miller consults for and holds stock in Fate Therapeutics, GT BioPharma, and Vycellix, as well as reports research funds from Fate Therapeutics and GT Biopharma; these interests have been reviewed and managed by the University of Minnesota in accordance with its conflict of interest policy. J.S. Miller serves on the Scientific Advisory Board of ONK Therapeutics, Wugan, and Sanofi; none of these relationships are related to the content of this manuscript. M.L. Davila reports grants from CRISPR during the conduct of the study. M.L. Davila also reports personal fees and other support from Bellicum and Adicet; personal fees from Capstan and CARGO; grants from Kite/Gilead and Novartis; and other support from Adaptive Biotechnologies outside the submitted work. In addition, M.L. Davila has a patent for CAR design pending to Atara and a patent for CD83 CAR pending to CRISPR. B.C. Betts reports personal fees and other support from CRISPR Therapeutics during the conduct of the study, as well as other support from VITRAC Therapeutics, Incyte, and CTI BioPharma outside the submitted work; in addition, B.C. Betts has a patent for WO2019165156 licensed to CRISPR Therapeutics. No disclosures were reported by the other authors.

Publisher Copyright:
© 2023 The Authors.

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Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1158/1078-0432.CCR-22-2837

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Holtan, S. G., Savid-Frontera, C., Walton, K., Eaton, A. A., Demorest, C., Hoeschen, A., Zhang, L., Reid, K., Kurian, T., Sayegh, Z., Julia, E., Maakaron, J., Bachanova, V., El Jurdi, N., MacMillan, M. L., Weisdorf, D. J., Felices, M., Miller, J. S., Blazar, B. R., ... Betts, B. C. (2023). Human Effectors of Acute and Chronic GVHD Overexpress CD83 and Predict Mortality. Clinical Cancer Research, 29(6), 1114-1124. https://doi.org/10.1158/1078-0432.CCR-22-2837

Holtan, SG, Savid-Frontera, C, Walton, K, Eaton, AA, Demorest, C, Hoeschen, A, Zhang, L, Reid, K, Kurian, T, Sayegh, Z, Julia, E, Maakaron, J , Bachanova, V , El Jurdi, N , MacMillan, ML , Weisdorf, DJ , Felices, M , Miller, JS , Blazar, BR, Davila, ML & Betts, BC 2023, 'Human Effectors of Acute and Chronic GVHD Overexpress CD83 and Predict Mortality', Clinical Cancer Research, vol. 29, no. 6, pp. 1114-1124. https://doi.org/10.1158/1078-0432.CCR-22-2837

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title = "Human Effectors of Acute and Chronic GVHD Overexpress CD83 and Predict Mortality",

abstract = "Purpose: Acute and chronic GVHD remain major causes of transplant-related morbidity and mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). We have shown CD83 chimeric antigen receptor (CAR) T cells prevent GVHD and kill myeloid leukemia cell lines. In this pilot study, we investigate CD83 expression on GVHD effector cells, correlate these discoveries with clinical outcomes, and evaluate critical therapeutic implications for transplant recipients. Experimental Design: CD83 expression was evaluated among circulating CD4+ T cells, B-cell subsets, T follicular helper (Tfh) cells, and monocytes from patients with/without acute or chronic GVHD (n = 48 for each group), respectively. CD83 expression was correlated with survival, TRM, and relapse after alloHCT. Differential effects of GVHD therapies on CD83 expression was determined. Results: CD83 overexpression on CD4+ T cells correlates with reduced survival and increased TRM. Increased CD83+ B cells and Tfh cells, but not monocytes, are associated with poor posttransplant survival. CD83 CAR T eliminate autoreactive CD83+ B cells isolated from patients with chronic GVHD, without B-cell aplasia as observed with CD19 CAR T. We demonstrate robust CD83 antigen density on human acute myeloid leukemia (AML), and confirm potent antileukemic activity of CD83 CAR T in vivo, without observed myeloablation. Conclusions: CD83 is a promising diagnostic marker of GVHD and warrants further investigation as a therapeutic target of both GVHD and AML relapse after alloHCT.",

author = "Holtan, {Shernan G.} and Constanza Savid-Frontera and Kelly Walton and Eaton, {Anne A.} and Connor Demorest and Andrea Hoeschen and Ling Zhang and Kayla Reid and Tony Kurian and Zena Sayegh and Estefania Julia and Joseph Maakaron and Veronika Bachanova and {El Jurdi}, Najla and MacMillan, {Margaret L.} and Weisdorf, {Daniel J.} and Martin Felices and Miller, {Jeffrey S.} and Blazar, {Bruce R.} and Davila, {Marco L.} and Betts, {Brian C.}",

note = "Funding Information: Our study received assistance from the Flow Cytometry Core Facility at the H. Lee Moffitt Cancer Center & Research Institute and the Flow Cytometry Resource at the University of Minnesota, both of which are NCI-designated Comprehensive Cancer Centers. This work was supported by funds from Masonic Cancer Center (BCB), Moffitt Cancer Center (MLD), CCSG grants at Moffitt and the Masonic Cancer Centers, and grant support including NHLBI R01 HL56067, R01 HL 11879, R01 HL 155114, and NIAID R37 AI 34495 (BRB). Funding Information: S.G. Holtan reports other support from Incyte and VITRAC Therapeutics outside the submitted work; in addition, S.G. Holtan serves as a clinical trial adjudicator for CSL Behring. A.A. Eaton reports grants from NCI during the conduct of the study, as well as grants from NIH outside the submitted work. J. Maakaron reports other support from Gilead, ADC Therapeutics, CRISPR, and Precision BioSciences outside the submitted work. D.J. Weisdorf reports grants from Fate Therapeutics and Incyte outside the submitted work. M. Felices reports personal fees from GT Biopharma outside the submitted work. J.S. Miller consults for and holds stock in Fate Therapeutics, GT BioPharma, and Vycellix, as well as reports research funds from Fate Therapeutics and GT Biopharma; these interests have been reviewed and managed by the University of Minnesota in accordance with its conflict of interest policy. J.S. Miller serves on the Scientific Advisory Board of ONK Therapeutics, Wugan, and Sanofi; none of these relationships are related to the content of this manuscript. M.L. Davila reports grants from CRISPR during the conduct of the study. M.L. Davila also reports personal fees and other support from Bellicum and Adicet; personal fees from Capstan and CARGO; grants from Kite/Gilead and Novartis; and other support from Adaptive Biotechnologies outside the submitted work. In addition, M.L. Davila has a patent for CAR design pending to Atara and a patent for CD83 CAR pending to CRISPR. B.C. Betts reports personal fees and other support from CRISPR Therapeutics during the conduct of the study, as well as other support from VITRAC Therapeutics, Incyte, and CTI BioPharma outside the submitted work; in addition, B.C. Betts has a patent for WO2019165156 licensed to CRISPR Therapeutics. No disclosures were reported by the other authors. Publisher Copyright: {\textcopyright} 2023 The Authors.",

year = "2023",

month = mar,

day = "15",

doi = "10.1158/1078-0432.CCR-22-2837",

language = "English (US)",

volume = "29",

pages = "1114--1124",

journal = "Clinical Cancer Research",

issn = "1078-0432",

publisher = "American Association for Cancer Research Inc.",

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TY - JOUR

T1 - Human Effectors of Acute and Chronic GVHD Overexpress CD83 and Predict Mortality

AU - Holtan, Shernan G.

AU - Savid-Frontera, Constanza

AU - Walton, Kelly

AU - Eaton, Anne A.

AU - Demorest, Connor

AU - Hoeschen, Andrea

AU - Zhang, Ling

AU - Reid, Kayla

AU - Kurian, Tony

AU - Sayegh, Zena

AU - Julia, Estefania

AU - Maakaron, Joseph

AU - Bachanova, Veronika

AU - El Jurdi, Najla

AU - MacMillan, Margaret L.

AU - Weisdorf, Daniel J.

AU - Felices, Martin

AU - Miller, Jeffrey S.

AU - Blazar, Bruce R.

AU - Davila, Marco L.

AU - Betts, Brian C.

N1 - Funding Information: Our study received assistance from the Flow Cytometry Core Facility at the H. Lee Moffitt Cancer Center & Research Institute and the Flow Cytometry Resource at the University of Minnesota, both of which are NCI-designated Comprehensive Cancer Centers. This work was supported by funds from Masonic Cancer Center (BCB), Moffitt Cancer Center (MLD), CCSG grants at Moffitt and the Masonic Cancer Centers, and grant support including NHLBI R01 HL56067, R01 HL 11879, R01 HL 155114, and NIAID R37 AI 34495 (BRB). Funding Information: S.G. Holtan reports other support from Incyte and VITRAC Therapeutics outside the submitted work; in addition, S.G. Holtan serves as a clinical trial adjudicator for CSL Behring. A.A. Eaton reports grants from NCI during the conduct of the study, as well as grants from NIH outside the submitted work. J. Maakaron reports other support from Gilead, ADC Therapeutics, CRISPR, and Precision BioSciences outside the submitted work. D.J. Weisdorf reports grants from Fate Therapeutics and Incyte outside the submitted work. M. Felices reports personal fees from GT Biopharma outside the submitted work. J.S. Miller consults for and holds stock in Fate Therapeutics, GT BioPharma, and Vycellix, as well as reports research funds from Fate Therapeutics and GT Biopharma; these interests have been reviewed and managed by the University of Minnesota in accordance with its conflict of interest policy. J.S. Miller serves on the Scientific Advisory Board of ONK Therapeutics, Wugan, and Sanofi; none of these relationships are related to the content of this manuscript. M.L. Davila reports grants from CRISPR during the conduct of the study. M.L. Davila also reports personal fees and other support from Bellicum and Adicet; personal fees from Capstan and CARGO; grants from Kite/Gilead and Novartis; and other support from Adaptive Biotechnologies outside the submitted work. In addition, M.L. Davila has a patent for CAR design pending to Atara and a patent for CD83 CAR pending to CRISPR. B.C. Betts reports personal fees and other support from CRISPR Therapeutics during the conduct of the study, as well as other support from VITRAC Therapeutics, Incyte, and CTI BioPharma outside the submitted work; in addition, B.C. Betts has a patent for WO2019165156 licensed to CRISPR Therapeutics. No disclosures were reported by the other authors. Publisher Copyright: © 2023 The Authors.

PY - 2023/3/15

Y1 - 2023/3/15

N2 - Purpose: Acute and chronic GVHD remain major causes of transplant-related morbidity and mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). We have shown CD83 chimeric antigen receptor (CAR) T cells prevent GVHD and kill myeloid leukemia cell lines. In this pilot study, we investigate CD83 expression on GVHD effector cells, correlate these discoveries with clinical outcomes, and evaluate critical therapeutic implications for transplant recipients. Experimental Design: CD83 expression was evaluated among circulating CD4+ T cells, B-cell subsets, T follicular helper (Tfh) cells, and monocytes from patients with/without acute or chronic GVHD (n = 48 for each group), respectively. CD83 expression was correlated with survival, TRM, and relapse after alloHCT. Differential effects of GVHD therapies on CD83 expression was determined. Results: CD83 overexpression on CD4+ T cells correlates with reduced survival and increased TRM. Increased CD83+ B cells and Tfh cells, but not monocytes, are associated with poor posttransplant survival. CD83 CAR T eliminate autoreactive CD83+ B cells isolated from patients with chronic GVHD, without B-cell aplasia as observed with CD19 CAR T. We demonstrate robust CD83 antigen density on human acute myeloid leukemia (AML), and confirm potent antileukemic activity of CD83 CAR T in vivo, without observed myeloablation. Conclusions: CD83 is a promising diagnostic marker of GVHD and warrants further investigation as a therapeutic target of both GVHD and AML relapse after alloHCT.

AB - Purpose: Acute and chronic GVHD remain major causes of transplant-related morbidity and mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). We have shown CD83 chimeric antigen receptor (CAR) T cells prevent GVHD and kill myeloid leukemia cell lines. In this pilot study, we investigate CD83 expression on GVHD effector cells, correlate these discoveries with clinical outcomes, and evaluate critical therapeutic implications for transplant recipients. Experimental Design: CD83 expression was evaluated among circulating CD4+ T cells, B-cell subsets, T follicular helper (Tfh) cells, and monocytes from patients with/without acute or chronic GVHD (n = 48 for each group), respectively. CD83 expression was correlated with survival, TRM, and relapse after alloHCT. Differential effects of GVHD therapies on CD83 expression was determined. Results: CD83 overexpression on CD4+ T cells correlates with reduced survival and increased TRM. Increased CD83+ B cells and Tfh cells, but not monocytes, are associated with poor posttransplant survival. CD83 CAR T eliminate autoreactive CD83+ B cells isolated from patients with chronic GVHD, without B-cell aplasia as observed with CD19 CAR T. We demonstrate robust CD83 antigen density on human acute myeloid leukemia (AML), and confirm potent antileukemic activity of CD83 CAR T in vivo, without observed myeloablation. Conclusions: CD83 is a promising diagnostic marker of GVHD and warrants further investigation as a therapeutic target of both GVHD and AML relapse after alloHCT.

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Human Effectors of Acute and Chronic GVHD Overexpress CD83 and Predict Mortality

Abstract

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