Table 3.
Overview of DC vaccine studies for AML in a post-remission setting.
| DC Type (Auto/Allo) | Antigen (Loading) | Immunological Effects | Clinical Effects | |
|---|---|---|---|---|
| n = 3 [33] | moDCs ◊ | WT1235 | Positive DTH (2/3) | Disease stabilization (1/3) |
| (autologous) | (pulsing) | ↑ WT1-specific T cells (2/2) | ↓ AML cell load (1/3) | |
| No ↑ γδ T cells | (morphological) | |||
| n = 5 [43,50] | moDCs | WT1/PRAME | Positive DTH (4) | Continued CR (21, 25, 33 m) (3) |
| (autologous) | (mRNA EP) | ↑ Ag-specific T cells (2) | ||
| n = 5 [51] | AML-DCs | NA | Minimal or absent DTH | Continued CR (13–16 m) (2) |
| (autologous) | ↑ AML-reactive T cells (4/4) | |||
| ↑ WT1-specific T cells (1/1) | ||||
| No ↑ Treg cells | ||||
| n = 5 [40] | moDCs | Apo-AML cells | ND | Continued CR (+13 m) (1) |
| (autologous) | (pulsing) | |||
| n = 12 [28] | AML-DCs | NA | Positive DTH | Disease stabilization (1) |
| (allogeneic) | ↑ WT1/PRAME-specific T cells | Disease stabilization (1) | ||
| Favorable OS in patients without circulating blasts | ||||
| n = 10/13 [44] | moDCs (autologous) | WT1/PRAME/CMVpp65 (mRNA EP) | Local immune response (10) ↑ Ag-specific T cells WT1 (2/10) PRAME (4/10) CMV (9/10) |
Favorable RFS (1084 days vs. 396 days in matched cohort) Prolonged RFS and OS in immune responders |
| n = 17 [42] | moDCs | AML cells | ↑ AML-reactive T cells (6) | Favorable RFS (71% at 57 m) |
| (autologous) | (fusion hybrids) | ↑ AML Ag-specific T cells (2) | ||
| (i.e., MUC1, WT1 or PRAME) | ||||
| n = 21 [45] | moDCs | hTERT | Positive DTH | Favorable RFS (58% at 52 m) |
| (autologous) | (mRNA EP) | ↑ hTERT-specfic T cells (11/19) | ||
| n = 30 [8,52] | moDCs | WT1 | Positive DTH | Induction of CMR (9) |
| (autologous) | (mRNA EP) | ↑ WT1-specific T cells | Disease stabilization (4) | |
| (in clinical responders) | Favorable RFS in responders | |||
| NK activation (4/10) | Favorable OS |
Abbreviations: n, number of DC-treated patients; DC type, type of DC used; auto, DCs from autologous origin; allo, DCs from allogeneic origin; moDCs, monocyte-derived DCs; ◊, pulsed with zoledronic acid in an attempt to induce γδ T-cell anti-leukemia immunity; AML-DCs, AML cell-derived DCs; Antigen, antigenic material used to load DCs; loading, antigen-loading method used; WT1235, designated epitope derived from Wilms’ tumor 1 (WT1) antigen; PRAME, preferentially expressed antigen in melanoma; mRNA EP, messenger RNA electroporation; NA, not applicable; Apo-AML cells, apoptotic AML cells; CMVpp65, Cytomegalovirus pp65 peptide; hTERT, human telomerase reverse transcriptase; DTH, delayed-type hypersensitivity test; ↑, increase; Ag, antigen; Treg, regulatory T cells; ND, no data; MUC1, mucin 1; NK, natural killer cell; ↓, decrease; CR, complete remission; CMR, complete molecular remission; RFS, relapse-free survival; OS, overall survival; (number), number of patients in whom the designated immunological or clinical effect was observed; (number m), follow-up time in months.