Natural killer cell therapy in children with relapsed leukemia

Pediatr Blood Cancer. 2015 Aug;62(8):1468-72. doi: 10.1002/pbc.25555. Epub 2015 Apr 30.

Abstract

Background: Novel therapies are needed for children with relapsed or refractory leukemia. We therefore tested the safety and feasibility of haploidentical natural killer cell therapy in this patient population.

Procedure: Twenty-nine children who had relapsed or refractory leukemia were treated with chemotherapy followed by the infusion of haploidentical NK cells. Cohort 1 included 14 children who had not undergone prior allogeneic hematopoietic cell transplantation (HCT), whereas Cohort 2 included 15 children with leukemia that had relapsed after HCT.

Results: Twenty-six (90%) NK donors were KIR mismatched (14 with one KIR and 12 with 2 KIRs). The peak NK chimerism levels were >10% donor in 87% of the evaluable recipients. In Cohort 1, 10 had responsive disease and 12 proceeded to HCT thereafter. Currently, 5 (36%) are alive without leukemia. In Cohort 2, 10 had responsive disease after NK therapy and successfully proceeded to second HCT. At present, 4 (27%) are alive and leukemia-free. The NK cell infusions and the IL-2 injections were well-tolerated.

Conclusions: NK cell therapy is safe, feasible, and should be further investigated in patients with chemotherapy-resistant leukemia.

Keywords: NK cell; cell therapy; childhood leukemia; relapse.

Publication types

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

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Child
  • Female
  • Humans
  • Immunotherapy, Adoptive / methods*
  • Killer Cells, Natural / immunology
  • Killer Cells, Natural / transplantation*
  • Leukemia / drug therapy
  • Leukemia / immunology
  • Leukemia / therapy*
  • Male
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / therapy*
  • Receptors, KIR / immunology
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Receptors, KIR