First described in 1975, natural killer cells are part of the innate immune system and have been recognized for their ability to kill malignant cells without prior sensitization. Recent studies suggest that these cells may play an important role in human cancer prevention and could be an effective tool in cancer immunotherapy.
Natural killer cells have been shown to kill transformed or virally infected cells without antigen priming. In addition, natural killer cells are able to protect against graft-versus-host disease.
In an editorial published in the journal Transfusion, Drs. David Shook and Wing Leung of St. Jude Children’s Research Hospital, discuss progress in the development of natural killer cell immunotherapy. They highlighted four studies also published in Transfusion.
Here is Dr. Shook. “Natural killer cell therapy holds considerable promise for the treatment of cancer, but many issues still remain- including which patients to treat and when, as well as how to collect, process, and infuse the cells. Recent studies are beginning to shed light on these important questions.”
One of these studies reviewed the methods for optimizing natural killer cell manufacturing, including the use of immunomagnetic beads to select cells, the use of feeder cells to promote proliferation, and the addition of cytokines to enhance manufacturing. Additional research explored the logistical constraints of implementing natural killer cell therapy and the potential feasibility of a distant central processing facility. An “in-flight” cell processing and transport system has been able to successfully ship cells between laboratories. The system was validated through a phase I clinical trial among cancer patients receiving haploidentical natural killer cell-enriched products.
Natural killer cell products are generally safe and tolerable. However, they are not entirely without risk. Researchers from the University of Minnesota reported two cases of significant hemolytic anemia after treatment with natural killer cell-enriched products with a minor ABO mismatch. They suggested that natural killer cells should be depleted of B cells to avoid similar complications. There is enormous potential for this therapy, and further research is needed to refine the use of natural killer cell therapy for cancer patients.
We’ll be back on February 28th with another edition of Transfusion News. Thanks for joining us.
References
1. Shook DR, Leung W: Natural killer cell therapy for cancer: Delivering on a promise. Transfusion 2013;53:245-248.
2. Koepsell SA, Miller JS, McKenna DH, Jr.: Natural killer cells: A review of manufacturing and clinical utility. Transfusion 2013;53:404-410.
3. Koepsell SA, Kadidlo DM, Fautsch S, McCullough J, Klingemann H, Wagner JE, Miller JS, McKenna DH, Jr.: Successful “in-flight” activation of natural killer cells during long-distance shipping. Transfusion 2013;53:398-403.
4. Klingemann H, Grodman C, Cutler E, Duque M, Kadidlo D, Klein AK, Sprague KA, Miller KB, Comenzo RL, Kewalramani T, Yu N, Van Etten RA, McKenna DH: Autologous stem cell transplant recipients tolerate haploidentical related-donor natural killer cell-enriched infusions. Transfusion 2013;53:412-418; quiz 411.
5. Skeate R, Singh C, Cooley S, Geller M, Northouse J, Welbig J, Slungaard A, Miller J, McKenna D: Hemolytic anemia due to passenger lymphocyte syndrome in solid malignancy patients treated with allogeneic natural killer cell products. Transfusion 2013;53:419-423.
