Natural killer cell therapy in children with relapsed leukemia.
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.


METHODS
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.
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Jeffrey E
JE
Rubnitz
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Hiroto
H
Inaba
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.
Guolian
G
Kang
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.
Kwan
K
Gan
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Christine
C
Hartford
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Brandon M
BM
Triplett
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Mari
M
Dallas
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
David
D
Shook
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Tanja
T
Gruber
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Ching-Hon
CH
Pui
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, College of, Medicine, Memphis, Tennessee.
Wing
W
Leung
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods*; D007694:Killer Cells, Natural / Q000276:immunology / Q000637:transplantation*; D007938:Leukemia / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000628:therapy*; D054340:Receptors, KIR / Q000276:immunology; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D054340:Receptors, KIR
NK cell; cell therapy; childhood leukemia; relapse