The broad, long-term objectives and specific aims are to increase hematopoietic cell donor availability, progression free and overall survival following allogeneic hematopoietic cell transplantation (HCT) for malignant diseases. One major obstacle for HCT is the lack of a suitable donor. We have developed a non myeloablative regimen that is the first step or platform in a process of graft engineering that will allow us to add other """"""""building blocks"""""""" for a more successful graft. Our results suggest that this alemtuzumab based non myeloablative regimen allows engraftment with low morbidity and treatment related mortality, allowing older, more infirmed patients to undergo allogeneic HCT. The primary limitations to greater success are relapse and delayed immune recovery. The central hypothesis of this project is that we will be able to engineer a graft that allows engraftment without graft versus host disease (GVHD). We will then build in a post transplant strategy to enhance anti tumor responses. Several complementary projects will be pursued in order to test this hypothesis. In the first aim, we will complete the feasibility study and early immune reconstitution analyses to provide a foundation and then focus on a larger phase II study enrolling better risk patients to confirm our initial observations.
This aim will be the foundation for the additional graft enhancements in Aims 2-4 and projects I, II, and III.
In Aim 2, we will continue our initial studies of addition of donor natural killer cell (NK) infusions following HCT and monitor immune responses against the tumor and overall immune recovery.
Aim 3 will begin our first series of studies using WT-1 as a target in hematolymphoid diseases. This first study of WT-1 will be the foundation for us to build upon additional strategies aimed at this tumor specific antigen.
Aim 4 will be to carry out a clinical study with the use of TLR ligands (initially CpG) along with Project III. This project will also serve as the information center for the early phase I studies that will be carried out in Project II. Each clinical study is supported by Cores A &B. The correlative analyses from each study are supplied by Core C. Thus this project serves as the clinical research for the other projects and interacts extensively with all three cores. The lessons learned from these trials will set the stage for future studies aimed at decreasing GVHD and relapse and improving long term survival.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Program Projects (P01)
Project #
5P01CA047741-17
Application #
8182363
Study Section
Special Emphasis Panel (ZCA1)
Project Start
Project End
Budget Start
2010-07-01
Budget End
2011-06-30
Support Year
17
Fiscal Year
2010
Total Cost
$981,749
Indirect Cost
Name
Duke University
Department
Type
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Brennan, Todd V; Lin, Liwen; Huang, Xiaopei et al. (2018) Generation of Luciferase-expressing Tumor Cell Lines. Bio Protoc 8:
Hippen, Keli L; Loschi, Michael; Nicholls, Jemma et al. (2018) Effects of MicroRNA on Regulatory T Cells and Implications for Adoptive Cellular Therapy to Ameliorate Graft-versus-Host Disease. Front Immunol 9:57
MacDonald, Kelli Pa; Blazar, Bruce R; Hill, Geoffrey R (2017) Cytokine mediators of chronic graft-versus-host disease. J Clin Invest 127:2452-2463
Du, Jing; Paz, Katelyn; Thangavelu, Govindarajan et al. (2017) Invariant natural killer T cells ameliorate murine chronic GVHD by expanding donor regulatory T cells. Blood 129:3121-3125
MacDonald, Kelli P A; Hill, Geoffrey R; Blazar, Bruce R (2017) Chronic graft-versus-host disease: biological insights from preclinical and clinical studies. Blood 129:13-21
Du, Jing; Paz, Katelyn; Flynn, Ryan et al. (2017) Pirfenidone ameliorates murine chronic GVHD through inhibition of macrophage infiltration and TGF-? production. Blood 129:2570-2580
Rowland, Christopher R; Colucci, Lina A; Guilak, Farshid (2016) Fabrication of anatomically-shaped cartilage constructs using decellularized cartilage-derived matrix scaffolds. Biomaterials 91:57-72
Flynn, Ryan; Paz, Katelyn; Du, Jing et al. (2016) Targeted Rho-associated kinase 2 inhibition suppresses murine and human chronic GVHD through a Stat3-dependent mechanism. Blood 127:2144-54
Brennan, Todd V; Lin, Liwen; Brandstadter, Joshua D et al. (2016) Heparan sulfate mimetic PG545-mediated antilymphoma effects require TLR9-dependent NK cell activation. J Clin Invest 126:207-19
Sung, Anthony D; Sung, Julia A M; Thomas, Samantha et al. (2016) Universal Mask Usage for Reduction of Respiratory Viral Infections After Stem Cell Transplant: A Prospective Trial. Clin Infect Dis 63:999-1006

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