The activity of allogeneic CD8 ؉ T cells specific for leukemia-associated antigens (LAAs) is thought to mediate, at least in part, the curative effects of hematopoietic stem cell transplantation (HSCT) in myeloid malignancies. However, the identity and nature of clinically relevant LAA-specific CD8 ؉ T-cell populations have proven difficult to define. Here, we used a combination of coreceptormutated peptide-major histocompatibility complex class I (pMHCI) tetramers and polychromatic flow cytometry to examine the avidity profiles, phenotypic characteristics, and anatomical distribution of HLA A*0201-restricted CD8 ؉ T-cell populations specific for LAAs that are over-expressed in myeloid leukemias. Remarkably, LAA-specific CD8 ؉ T-cell populations, regardless of fine specificity, were confined almost exclusively to the bone marrow; in contrast, CD8 ؉ T-cell populations specific for the HLA A*0201-restricted cytomegalovirus (CMV) pp65 495-503 epitope were phenotypically distinct and evenly distributed between bone marrow and peripheral blood. Furthermore, bone marrow-resident LAA-specific CD8 ؉ T cells frequently engaged cognate antigen with high avidity; notably, this was the case in all tested bone marrow samples derived from patients who achieved clinical remission after HSCT. These data suggest that concomitant examination of bone marrow specimens in patients with myeloid leukemias might yield more definitive information in the search for immunologic prognostica-
IntroductionAllogeneic hematopoietic stem cell transplantation (HSCT) can be curative in a large proportion of patients with myeloid malignancies and there is substantial evidence to support the notion that this is mediated, at least to some extent, by a graft-versus-leukemia (GVL) effect. 1 However, the precise identity of the allogeneic leukemia-reactive T cells that are responsible for the GVL effect remains obscure. It is established that certain proteins are overexpressed in leukemic states. Peptides derived from these proteins can be displayed at high densities bound to major histocompatibility complex class I (MHCI) molecules on the cell surface and act as leukemia-associated antigens (LAAs) for immune recognition. 2 Two such well-studied LAAs that are known to elicit human leukocyte antigen (HLA) A*0201-restricted CD8 ϩ T-cell responses are the PR3 169-177 /HNE 168-176 (PR1) and WT1 126-134 epitopes derived from proteinase 3/human neutrophil elastase and Wilms tumor antigen-1, respectively. [3][4][5][6][7][8] The selective recognition and elimination of leukemic but not healthy hematopoietic progenitor cells by CD8 ϩ T cells specific for indicates that these LAAs might be useful target antigens for immunotherapeutic interventions. However, it remains unclear to what extent such LAA-specific CD8 ϩ T-cell responses mediate protective effects in vivo before and after HSCT. 9 In part, this reflects limitations of current technological approaches to the detection of low frequency antigen-specific CD8 ϩ T cells directly ex vivo; furthermore, for re...