Supplementary Figures S1-6. Figure S1: Histological staging criteria for acute GvHD Figure S2: Ruxolitinib does not impair post-transplant donor myeloid reconstitution and full donor chimerism. Figure S3: GVT effect against myeloid leukemia RMB-1 cell line is maintained in the presence of ruxolitinib Figure S4: Ruxolitinib at the dose of 90 mg/Kg prevents acute GVHD without affecting T cell alloreactivity Figure S5: Ruxolitinib effect at 45 mg/Kg on absolute numbers of alloreactive T cells, Th17 and Treg cells. Figure S6: Representative Images of Ruxolitinb effect on T cells and macrophage infiltration of GVHD organs
ARTICLE ABSTRACT
Purpose: Immune-mediated graft-versus-tumor (GVT) effects can occur after allogeneic hematopoietic stem cell transplantation (HSCT), but GVT is tightly linked to its main complication, graft-versus-host disease (GVHD). Strategies aimed at modulating GVHD, while maintaining the GVT effect, are needed to improve the cure rate of transplant. Given the emerging role of Janus-activated kinase (JAK) signaling in lymphoproliferative and myeloproliferative diseases and its established function at dictating T-cell differentiation, we postulated that JAKs might be potential therapeutic targets through a pharmacologic approach.Experimental Design: We examined the effect of JAK1/JAK2 modulation by ruxolitinib in a mouse model of fully MHC mismatched bone marrow transplant comprising in vivo tumor inoculation.Results: JAK1/JAK2 inhibition by ruxolitinib improved both overall survival (P = 0.03) and acute GVHD pathologic score at target organs (P ≤ 0.001) of treated mice. In addition, treatment with ruxolitinib was associated with a preserved GVT effect, as evidenced by reduction of tumor burden (P = 0.001) and increase of survival time (P = 0.01). JAK1/JAK2 inhibition did not impair the in vivo acquisition of donor T-cell alloreactivity; this observation may account, at least in part, to the preserved GVT effect. Rather, JAK1/JAK2 inhibition of GVHD was associated with the modulation of chemokine receptor expression, which may have been one factor in the reduced infiltration of donor T cells in GVHD target organs.Conclusions: These data provide further evidence that JAK inhibition represents a new and potentially clinically relevant approach to GVHD prevention. Clin Cancer Res; 21(16); 3740–9. ©2015 AACR.
