[HTML][HTML] Selective hematopoietic stem cell ablation using CD117-antibody-drug-conjugates enables safe and effective transplantation with immunity preservation

A Czechowicz, R Palchaudhuri, A Scheck… - Nature …, 2019 - nature.com
Nature communications, 2019nature.com
Hematopoietic stem cell transplantation (HSCT) is a curative therapy for blood and immune
diseases with potential for many settings beyond current standard-of-care. Broad HSCT
application is currently precluded largely due to morbidity and mortality associated with
genotoxic irradiation or chemotherapy conditioning. Here we show that a single dose of a
CD117-antibody-drug-conjugate (CD117-ADC) to saporin leads to> 99% depletion of host
HSCs, enabling rapid and efficient donor hematopoietic cell engraftment. Importantly …
Abstract
Hematopoietic stem cell transplantation (HSCT) is a curative therapy for blood and immune diseases with potential for many settings beyond current standard-of-care. Broad HSCT application is currently precluded largely due to morbidity and mortality associated with genotoxic irradiation or chemotherapy conditioning. Here we show that a single dose of a CD117-antibody-drug-conjugate (CD117-ADC) to saporin leads to > 99% depletion of host HSCs, enabling rapid and efficient donor hematopoietic cell engraftment. Importantly, CD117-ADC selectively targets hematopoietic stem cells yet does not cause clinically significant side-effects. Blood counts and immune cell function are preserved following CD117-ADC treatment, with effective responses by recipients to both viral and fungal challenges. These results suggest that CD117-ADC-mediated HSCT pre-treatment could serve as a non-myeloablative conditioning strategy for the treatment of a wide range of non-malignant and malignant diseases, and might be especially suited to gene therapy and gene editing settings in which preservation of immunity is desired.
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