Abstract

Tumor immunotherapy using gene-modified T cells has already met with considerable success in the treatment of metastatic melanoma and B cell lymphoma. With improving patient prognoses, new questions arise. In particular, the long-term consequences of treatment among individuals of childbearing age could now be considered. Former patients can carry a cohort of transgenic memory T cells long after treatment has ceased and the effector T cell population has contracted. When patients become parents well after treatment is completed, expectant mothers may still pass transgenic T cells to their unborn children. Consequences should be more measurable if the mother also breastfeeds the baby. Maternal T cells may shape immune responses in the child, can tolerize the child to maternal antigens, and might cause either beneficial or adverse effects in the offspring. The hypothesis put forth is that transgenic T cells transferred from mother to child during and after pregnancy might have consequences that have not been adequately considered to date. Depending on the targeted antigen and the MHC eventually required to present it, such transfer may be beneficial, uneventful or even damaging. Such potential consequences are addressed in this paper. The transgenic T cells might form a pocket of memory T cells in secondary lymphoid organs of the child, expand upon antigen stimulation, and react. However, simple measures might be devised to avoid any reason for concern. These considerations provide ample incentive to probe transgenerational transfer of transgenic T cells.

Highlights

  • The hypothesis put forth in this paper is that transgenic T cells adoptively transferred into a woman during therapy may, during and after a future pregnancy, be passed to her unborn child and that these T cells could have consequences for the child

  • The magnitude of this event depends on the odds that such T cells are transferred and on the opportunities for such T cells to interact with tissue cells in the new host

  • Transgenic T cell transfer The role of maternal T cells in immune education raises concerns regarding the potential transfer of transgenic T cells after cancer immunotherapy

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Summary

Introduction

Introduction The hypothesis put forth in this paper is that transgenic T cells adoptively transferred into a woman during therapy may, during and after a future pregnancy, be passed to her unborn child and that these T cells could have consequences for the child. This paper is meant to initiate a discussion about the potential transfer of transgenic T cells during pregnancy As a consequence of NIMA transfer, the child will develop immune tolerance to maternal antigens, including HLA.

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