Patients with acute myeloid leukaemia who relapse following therapy have few treatment options and face poor outcomes. Immune checkpoint inhibition, for example, by antibody-mediated programmed death-1 (PD-1) blockade, is a potent therapeutic modality that improves treatment outcomes in acute myeloid leukaemia. Here, we show that systemically delivered blood platelets decorated with anti-PD-1 antibodies (aPD-1) and conjugated to haematopoietic stem cells (HSCs) suppress the growth and recurrence of leukaemia in mice. Following intravenous injection into mice bearing leukaemia cells, the HSC–platelet–aPD-1 conjugate migrated to the bone marrow and locally released aPD-1, significantly enhancing anti-leukaemia immune responses, and increasing the number of active T cells, production of cytokines and chemokines, and survival time of the mice. This cellular conjugate also promoted resistance to re-challenge with leukaemia cells. Taking advantage of the homing capability of HSCs and in situ activation of platelets for the enhanced delivery of a checkpoint inhibitor, this cellular combination-mediated drug delivery strategy can significantly augment the therapeutic efficacy of checkpoint blockade.
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The data supporting the findings of this study are available within the paper and its Supplementary Information. Source data for the figures are available in Figshare at https://doi.org/10.6084/m9.figshare.7033481.
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This work was supported by grants from the start-up packages of UNC/NC State and UCLA, the Sloan Research Fellowship of the Alfred P. Sloan Foundation, the National Key R&D Program of China (2017YFA0205600), the National Natural Science Foundation of China (51728301, 81690263) and the China Scholarship Council (CSC). We acknowledge B. Blazar at the University of Minnesota for providing the C1498-Luc cell line and M. Liu at New York University for assistance in cytokine analysis. Z.G. acknowledges support from W. Gu and P. Zhang.
Patents describing the cell-combination drug-delivery system documented in this article have been filed with the US Patent Office. Q.H. and Z.G. are inventors of the following provisional patent application: US 62/653,843. J.F.Z. has received honoraria from Agios, Celgene and Tolero, consultancy from Celgene and Asystbio Laboratories, and research funding from Merck, Takeda and Tolero. The other authors declare no competing interests.
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Hu, Q., Sun, W., Wang, J. et al. Conjugation of haematopoietic stem cells and platelets decorated with anti-PD-1 antibodies augments anti-leukaemia efficacy. Nat Biomed Eng 2, 831–840 (2018). https://doi.org/10.1038/s41551-018-0310-2
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