Inhibition of acute graft-versus-host disease with retention of graft-versus-tumor effects by the proteasome inhibitor bortezomib

K Sun, LA Welniak… - Proceedings of the …, 2004 - National Acad Sciences
K Sun, LA Welniak, A Panoskaltsis-Mortari, MJ O'Shaughnessy, H Liu, I Barao, W Riordan…
Proceedings of the National Academy of Sciences, 2004National Acad Sciences
Graft-versus-host disease (GVHD) represents a major hurdle impeding the efficacy of
allogeneic bone marrow transplantation (BMT). Bortezomib is a proteasome inhibitor that
was recently approved for treatment of myeloma. We found that bortezomib potently
inhibited in vitro mixed lymphocyte responses and promoted the apoptosis of alloreactive T
cells. Bortezomib given at the time of allogeneic BMT in mice resulted in significant
protection from acute GVHD. Reductions in GVHD-associated parameters and biological …
Graft-versus-host disease (GVHD) represents a major hurdle impeding the efficacy of allogeneic bone marrow transplantation (BMT). Bortezomib is a proteasome inhibitor that was recently approved for treatment of myeloma. We found that bortezomib potently inhibited in vitro mixed lymphocyte responses and promoted the apoptosis of alloreactive T cells. Bortezomib given at the time of allogeneic BMT in mice resulted in significant protection from acute GVHD. Reductions in GVHD-associated parameters and biological evidence of proteasome inhibition were observed with this regimen but with no adverse effects on long-term donor reconstitution. Assessment of graft-versus-tumor responses in advanced leukemia-bearing mice demonstrated that only the combination of allogeneic BMT and T cells with bortezomib promoted significant increases in survival. Increased cytotoxic T cell killing of the tumor was also observed. Thus, the combination of proteasome inhibition with selective immune attack can markedly increase the efficacy of BMT in cancer.
National Acad Sciences