Enhanced potency of immunotherapy against B-cell precursor acute lymphoblastic leukemia by combination of an Fc-engineered CD19 antibody and CD47 blockade

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Denis M. Schewe - , Otto von Guericke University Magdeburg (Author)
  • Fotini Vogiatzi - , Kiel University (Author)
  • Ira A. Münnich - , Ludwig Maximilian University of Munich (Author)
  • Tobias Zeller - , Ludwig Maximilian University of Munich (Author)
  • Roland Windisch - , Ludwig Maximilian University of Munich (Author)
  • Christian Wichmann - , Ludwig Maximilian University of Munich (Author)
  • Kristina Müller - , Kiel University (Author)
  • Hilal Bhat - , Otto von Guericke University Magdeburg (Author)
  • Elisa Felix - , Otto von Guericke University Magdeburg (Author)
  • Dimitrios Mougiakakos - , Otto von Guericke University Magdeburg (Author)
  • Heiko Bruns - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Lennart Lenk - , Kiel University (Author)
  • Thomas Valerius - , Kiel University (Author)
  • Andreas Humpe - , Ludwig Maximilian University of Munich (Author)
  • Matthias Peipp - , Kiel University (Author)
  • Christian Kellner - , Ludwig Maximilian University of Munich (Author)

Abstract

CD19-directed immunotherapy has become a cornerstone in the therapy of B-cell precursor acute lymphoblastic leukemia (BCP-ALL). CD19-directed cellular and antibody-based therapeutics have entered therapy of primary and relapsed disease and contributed to improved outcomes in relapsed disease and lower therapy toxicity. However, efficacy remains limited in many cases due to a lack of therapy response, short remission phases, or antigen escape. Here, BCP-ALL cell lines, patient-derived xenograft (PDX) samples, human macrophages, and an in vivo transplantation model in NOD.Cg-PrkdcscidIl2rgtm1Wjl/SzJ (NSG) mice were used to examine the therapeutic potency of a CD19 antibody Fc-engineered for improved effector cell recruitment (CD19-DE) and antibody-dependent cellular phagocytosis (ADCP), in combination with a novel modified CD47 antibody (Hu5F9-IgG2σ). For the in vivo model, only samples refractory to CD19-DE monotherapy were chosen. Hu5F9-IgG2σ enhanced ADCP by CD19-DE in various BCP-ALL cell line models with varying CD19 surface expression and cytogenetic backgrounds, two of which contained the KMT2A-AFF1 fusion. Also, the antibody combination was efficient in inducing ADCP by human macrophages in pediatric PDX samples with and adult samples with and without KMT2A-rearrangement in vitro. In a randomized phase 2-like PDX trial using seven KMT2A-rearranged BCP-ALL samples in NSG mice, the CD19/CD47 antibody combination proved highly efficient. Our findings support that the efficacy of Fc-engineered CD19 antibodies may be substantially enhanced by a combination with CD47 blockade. This suggests that the combination may be a promising therapy option for BCP-ALL, especially in relapsed patients and/or patients refractory to CD19-directed therapy.

Details

Original languageEnglish
Article numbere48
JournalHemaSphere
Volume8
Issue number2
Publication statusPublished - 22 Feb 2024
Peer-reviewedYes
Externally publishedYes

Keywords

Sustainable Development Goals

ASJC Scopus subject areas