The glycosaminoglycan oncofetal chondroitin sulfate is a novel target for antibody-drug conjugate therapy for AML

J Joana Mujollari (1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) M Montserrat Estruch (4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) P Priya Khadgawat (4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) S Swati Choudhary (1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) T Tobias Gustavsson (1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) R Robert Dagil (1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) N Norbert Redlinger (6Institute of Molecular Biochemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria) C Caroline Løppke (1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) E Elena Ethel Vidal-Calvo (1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) M Mie Anemone Nordmaj (1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) T Thor Grundtvig Theander O Olaf Heidenreich (1Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom) Y Yen Nguyen (4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) S Shuyu Qin (4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) A Anne Louise Tølbøll Sørensen (10Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark) K Kirsten Grønbæk (4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) B Bo Torben Porse (4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark) B Brigitte Kircher (7Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria) J Jan Mueller (6Institute of Molecular Biochemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria) M Mette Ørskov Agerbæk A Ali Salanti K Kim Theilgaard-Mönch (4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark)

Abstract

Abstract Antibody-drug conjugates (ADCs) have emerged as promising targeted therapies for acute myeloid leukemia (AML). However, most ADCs exhibit off-target binding to normal hematopoietic stem and myeloid progenitor cells, resulting in adverse hematotoxicity and narrow therapeutic windows, thereby limiting their clinical application to young and fit patients with AML who are eligible for intensive curative therapies. Proteoglycans with high levels of the glycosaminoglycan oncofetal chondroitin sulfate (ofCS) are abundantly expressed in solid cancers but are absent or expressed at low levels in normal adult tissues. Here, we report high ofCS levels on bone marrow (BM) cells from patients with AML and patient-derived xenografts (PDXs) from these patients, whereas BM cells from healthy individuals showed low or undetectable ofCS levels. Consistently, an anti-ofCS antibody demonstrated binding to and internalization into AML cells, and anti-ofCS ADCs effectively killed AML cells in vitro. Moreover, anti-ofCS ADC treatment significantly prolonged survival of AML PDXs compared with controls and was associated with low toxicity. Thus, anti-ofCS ADCs could represent an effective therapy with acceptable toxicity for patients with AML, including those who are ineligible for or unresponsive to current intensive curative therapies. In conclusion, this study demonstrates, to our knowledge for the first time, that a glycosaminoglycan-like ofCS is a druggable target for the development of effective antibody-based AML therapies.

Article Details

Journal Blood
Volume / Issue Vol. 147, Issue 11
Published March 12, 2026
Pages 1229-1236
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (22)

J

Joana Mujollari

1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

M

Montserrat Estruch

4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

P

Priya Khadgawat

4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

S

Swati Choudhary

1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

T

Tobias Gustavsson

1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

R

Robert Dagil

1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

N

Norbert Redlinger

6Institute of Molecular Biochemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria

C

Caroline Løppke

1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

E

Elena Ethel Vidal-Calvo

1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

M

Mie Anemone Nordmaj

1Centre for translational Medicine and Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

T

Thor Grundtvig Theander

O

Olaf Heidenreich

1Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom

Y

Yen Nguyen

4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

S

Shuyu Qin

4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

A

Anne Louise Tølbøll Sørensen

10Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

K

Kirsten Grønbæk

4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

B

Bo Torben Porse

4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

B

Brigitte Kircher

7Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria

J

Jan Mueller

6Institute of Molecular Biochemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria

M

Mette Ørskov Agerbæk

A

Ali Salanti

K

Kim Theilgaard-Mönch

4Biotech Research and Innovation Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark