; PROJECT 4 : Immune Tolerance and Stem Cell Transplantation Impaired immune responses are common in cancer and a particular feature of chronic lymphocytic leukemia (CLL). The immune dyfuction in CLL is characterised by hypogammaglobulinemia and autoimmune phenomena and infectious complications are a major cause of morbidity and mortality in this disease. Previous work in this Program has demonstrated a direct effect of CLL cells on T cells, both in human samples and in the Eji-TCL1 transgenic mouse model of this disease, that result in changes in actin polymerization in T and NK cells and failure of these cells to mount effective immune synapses with antigen presenting cells. The central hypothesis of this project Is that specific T cell defects result from interaction of CLL cells with the patient's immune system and that repair of these defects will be required to maximize T cell mediated immune responses in vivo. We therefore seek to characterize the basis for defective immune cell function in CLL and repair these defects for future therapeutic intervention. We shall examine this in human samples from patients with CLL and in an E(i-TCL1 transgenic mouse model of this disease. Since most agents that are used to treat CLL also add to the immune suppression, the project will determine whether novel agents in clinical trials in this Program have impact on the host immune system and are therefore likely to worsen immune function. Work will also be performed to assess the nature of T cell mediated anti-tumor immune responses against CLL cells and to determine if these specific T cell responses occur following allogeneic stem cell transplantation for CLL. The goal here is to characterize the nature ofthe graft versus leukemia effect in CLL. To address these issues this project will address the following specific aims: First, to define the molecular mechanism whereby molecules expressed by CLL cells induce dysfunction in T and NK cell in patients with CLL and the role of immunomodulatory drug intervention to repair these defects. The goal here is to improve immune function in CLL patients. Second, to assess the impact of in prevention of induction of T cell defects vivo in the Emu-TCLI transgenic mouse model of CLL and asses its impact on disease progression. Third, to characterize targets of graft versus leukemia effect in CLL after allogeneic stem cell transplantation in CTN/ CALGB 100701. Taken together, these studies will assess the impact of immune mediated responses in CLL.
This project has demonstrated that CLL cells induce defects in the host immune. In keeping with our original hypothesis that CLL would act as a model disease, based on this knowledge, we have demonstrated similar defects in actin polymerization in T cells in patients with other hematologic malignancies including acute myeloid leukemia, follicular lymphoma, diffuse large cell lymphoma, myeloma, breast, ovarian and pancreatic cancer. Findings from this Project therefore have broad implications in cancer.
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