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Almeida et al. SUPPLEMENTAL INFORMATION Supplemental Methods Isolation of human peripheral blood γδ T cells 50-150ml of fresh peripheral blood or buffy coat units were obtained from healthy volunteers and 15ml of fresh peripheral blood were obtained from CLL patients. Blood from Buffy Coat units was used undiluted and fresh blood samples were used diluted in a 1:1 ratio (volume-to-volume) with PBS. Blood/PBS was centrifuged in Ficol-Paque (Histopaque-1077; Sigma- Aldrich) in a volume ratio of 1:3 (1 part ficol to 3 parts blood) for 35 minutes at 1.500 rpm and 25°C. The interphase containing mononuclear cells (PBMCs) was collected and washed (in PBS). Unwanted TCRαβ + T lymphocytes were labelled by incubation in the presence of a murine anti-TCRαβ monoclonal antibody conjugated to Biotin (clone BW242/412), according to manufacturer’s instructions (Miltenyi Biotec GmbH, Germany). Cells were labelled with a murine anti-Biotin mAb coupled to magnetic microbeads. The cell suspension was loaded onto a LS magnetic column (Miltenyi Biotec) and TCRαβ + T lymphocytes were magnetically depleted (and discarded). CD3 + cells present in the remaining cell population were labelled with a murine anti-CD3 mAb (Miltenyi Biotec, clone OKT-3), conjugated to superparamagnetic iron dextran particles. Cells were loaded onto a LS magnetic separation column and CD3 + cells were positively selected. Cells were labelled with the following fluorescent antibodies: anti-CD3–PerCP-Cy5.5 (Biolegend; clone SK7); anti- TCR-Vδ1 -APC (Miltenyi Biotec, clone REA173); 1

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Almeida et al.

SUPPLEMENTAL INFORMATION

Supplemental Methods

Isolation of human peripheral blood γδ T cells

50-150ml of fresh peripheral blood or buffy coat units were obtained from healthy volunteers and 15ml of fresh peripheral blood were obtained from CLL patients. Blood from Buffy Coat units was used undiluted and fresh blood samples were used diluted in a 1:1 ratio (volume-to-volume) with PBS. Blood/PBS was centrifuged in Ficol-Paque (Histopaque-1077; Sigma-Aldrich) in a volume ratio of 1:3 (1 part ficol to 3 parts blood) for 35 minutes at 1.500 rpm and 25°C. The interphase containing mononuclear cells (PBMCs) was collected and washed (in PBS). Unwanted TCRαβ+ T lymphocytes were labelled by incubation in the presence of a murine anti-TCRαβ monoclonal antibody conjugated to Biotin (clone BW242/412), according to manufacturer’s instructions (Miltenyi Biotec GmbH, Germany). Cells were labelled with a murine anti-Biotin mAb coupled to magnetic microbeads. The cell suspension was loaded onto a LS magnetic column (Miltenyi Biotec) and TCRαβ+ T lymphocytes were magnetically depleted (and discarded). CD3+ cells present in the remaining cell population were labelled with a murine anti-CD3 mAb (Miltenyi Biotec, clone OKT-3), conjugated to superparamagnetic iron dextran particles. Cells were loaded onto a LS magnetic separation column and CD3+ cells were positively selected. Cells were labelled with the following fluorescent antibodies: anti-CD3–PerCP-Cy5.5 (Biolegend; clone SK7); anti- TCR-Vδ1 -APC (Miltenyi Biotec, clone REA173); anti–Mouse IgG1κ-APC Isotype Ctrl (Miltenyi Biotec; clone IS5-21F5), and analysed on a Fortessa II flow cytometer (BD Biosciences).

In vivo experimental design

We used a previously described model of xenografted human CLL upon sub-cutaneous adoptive transfer of CLL/SLL-derived MEC-1 cells into Balb/cRag-/-c-/- (BRG) animals, which we further adapted using NOD-SCIDγc-/- (NSG) animals as hosts. In order to ensure that animals receiving treatment or PBS control were tumor-bearing animals, we transduced MEC-1 CLL cells with firefly-luciferase in order to detect and measure tumor engraftment at early time-points before ascribing treatment cells. After 7 or 4 days (in different studies) we injected luciferin i.p. to determine tumour load as a function of luminescence, before ascribing treatment (or PBS control) to the animals. Animals were distributed randomly in cages and assigned to each treatment (PBS or DOT-Cells) according to luminescence measured at day 7, in such a way that animal with highest luminescence received treatment, second highest received PBS, third highest received treatment, etc. This resulted in a non-randomized distribution into groups but randomized distribution in the different cages. 2 additional animals received DOT-Cells in the indicated experiments for initial homing analysis. We performed two 107 or 2x107 DOT-Cells transfers (within 5 days), using cells from one different donor per experiment. Tumor was measured using a Caliper and taking three perpendicular measurements. The formula used was ½ x L x W x H. (1). Animals were sacrificed when tumor measurements reached 1000mm3.

Luminescence Analysis

After transduction of MEC-1 Cell line with GFP-firefly luciferase, growing cells were screened and sorted according to GFP expression using a FACS-Aria (Becton Dickinson, USA), up to >95% GFP positive cells. These cells were then kept in culture until transferred subcutaneous into host animals (in 50µl PBS). At the indicated time points after transfer, animals were anesthetized (Ketamin/Medetomidine) and Luciferin was injected (i.p.). 4 min later luciferase activity was detected and acquired using IVIS Lumina (Calliper LifeSciences) at the IMM bioimaging facilities. Anesthesia was then reverted and animals returned to previous housing.

Lymphocyte counts

Cell counts were performed with a hemocytometer or using Accuri Flow cytometer (Becton Dickinson, USA). Counts per organ were estimated when parts of the organ were sampled for histological analysis by weighting organs before and after the samples were split. Numbers presented are then corrected for the whole organ. In Bone Marrow data, absolute numbers were calculated and are displayed for one femur.

Histopathology and Immunohistochemistry

Mice were sacrificed with anesthetic overdose, necropsies were performed and selected organs (lung, heart, intestine, spleen, liver, kidney, reproductive tract, brain, cerebellum, spinal cord, and femur) were harvested, fixed in 10% neutral-buffered formalin, embedded in paraffin and 3μm sections were stained with hematoxylin and eosin (H&E). Bones were further decalcified in Calci-Clear™ (Fisher Scientific) prior to embedding. Tissue sections were examined by a pathologist, blinded to experimental groups, in a Leica DM2500 microscope coupled to a Leica MC170 HD microscope camera. Immunohistochemical staining for CD3 (Dako, cat. no. A0452) was performed by the Histology and Comparative Pathology Laboratory at the IMM, using standard protocols, with a Dako Autostainer Link 48. Antigen heat-retrieval was performed in DAKO PT link with low pH solution (pH 6), and incubation with ENVISION kit (Peroxidase/DAB detection system, DAKO, Santa Barbara, CA) was followed by Harri’s hematoxylin counterstaining (Bio Otica, Milan, IT). Negative control included the absence of primary antibodies; and CD3 staining was not observed in the negative controls. Images were acquired in a Leica DM2500 microscope, coupled with a Leica MC170 HD microscope camera.

Mouse Blood Biochemistry

Mice were deeply anaesthetised and blood was collected from the heart to heparin-coated tubes, sent for analysis of biochemical parameters shown at an independent laboratory. Biochemical parameters were measured in serum, in a RX monaco clinical chemistry analyser (RANDOX).

Supplemental Tables

Table S1. Reagents and materials used to produce pharmaceutical grade DOT-cells.

Reagent / Material

Manufacturer

Product reference

Manufacturing quality system*

For magnetic depletion of TCRα/β+ cells:

CliniMACS® Plus Instrument

Miltenyi Biotec, GmbH

151-01

cGMP, ISO 13485 compliant

CliniMACS® TCRα/β Kit

200-070-407

CliniMACS® Depletion Tubing Set

261-01

CliniMACS® PBS/EDTA Buffer

700-25

For magnetic enrichment of CD3+ cells:

CliniMACS® CD3 reagent

Miltenyi Biotec, GmbH

273-01

cGMP, ISO 13485 compliant

CliniMACS® Tubing Set TS

161-01

For cell culture:

Cell culture cassettes

Saint-Gobain

CC-0500

cGMP, 21 CFR 820 compliant

Clamps

Saint-Gobain

1C-0022

VueLife® cell culture FEP bag

Saint-Gobain

750-C1

OpTmizer™ T-cell expansion medium

Thermo Fisher Scientific

A10485-01

cGMP, ISO 13485:2003 or ISO 9001:2008 compliant

L-Glutamine

Thermo Fisher Scientific

25030-032

Human anti-CD3 mAb (clone OKT-3)

Miltenyi Biotec, GmbH

170-076-116

Recombinant Human IL-4

CellGenix GmbH

1003-050

Recombinant Human IL-21

CellGenix GmbH

1019-050

Recombinant Human IFN-γ

R&D Systems

285-GMP

Recombinant Human IL-1β

CellGenix GmbH

1011-050

Recombinant Human IL-15

CellGenix GmbH

1013-050

*Note: Some products are sold as certified medical devices for use in the EU and/or US. All other products are sold for further manufacturing of cell-based products for clinical research. They can be used in clinical trials under Investigational New Drug (IND) or Investigational Device Exemption (IDE) applications.

TCR agonists

Monoclonal antibodies (soluble and plate-bound)

anti-human TCR Vδ1 mAb (Clone TS8.2) ; purified

anti-human TCR δTCS-1 mAb (Clone TS-1) ; purified

anti-human TCR PAN γδ mAb (Clone IMMU510); purified

anti-human CD3 mAb (Clone OKT3) ; purified

Thermo Fisher Sci.

Thermo Fisher Sci.

Beckman Coulter

BioXcell/ Biolegend

Plant lectins

(soluble)

Lectin from Phaseolus vulgaris (red bean ; PHA-P), pur.

Concanavalin A (from Canavalia ensiformis; Con-A), pur.

Lectin from Phytolacca americana ; purified

Lectin from Triticum vulgaris (wheat) ; purified

Lectin from Lens culinaris (lentil) ; purified

Lectin from Glycine max (soybean) ; purified

Lectin from Maackia amurensis ; purified

Lectin from Pisum sativum (pea) ; purified

Lectin from Sambucus nigra (elder) ; purified

Sigma-Aldrich, Co.

Co-receptor agonists

Monoclonal antibodies (soluble and plate-bound)

anti-human CD2 mAb (Clone S5.2); purified

anti-human CD6 mAb (Clone UMCD6/3F7B5); purified

anti-human CD9 mAb (Clone MEM-61); purified

anti-human CD28 mAb (Clone CD28.2); purified

anti-human CD43 mAb (Clone MEM-59); purified

anti-human CD94 mAb (Clone HP-3B1); purified

anti-human CD160 mAb (Clone CL1-R2); purified

anti-human SLAM mAb [Clone A12(7D4)]; purified

anti-human NKG2D mAb (Clone 1D11); purified

anti-human 2B4 mAb (Clone C1.7); purified

anti-human HLA-A,B,C mAb (Clone W6/32) ; purified

anti-human ICAM-3 mAb (Clone MEM-171); purified

anti-human ICOS mAb (Clone C398.4A); purified

BD Biosciences

Ancell Corporation

Exbio Praha, a.s.

Biolegend

Exbio Praha, a.s.

Santa Cruz Biotech

Novus Biologicals

Biolegend

Exbio Praha, a.s.

Biolegend

Biolegend

Exbio Praha, a.s.

Biolegend

Recombinant proteins

(soluble)

Human SECTM-1/Fc Chimera (CD7 ligand)

Human CD26 (Dipeptidyl Peptidase IV)

Human CD27L (CD27 ligand);

Human CD30L (CD30 ligand);

Human CD40L (CD40 ligand);

Human OX40L (OX40 ligand);

Human 4-1BBL (4-1BB ligand)

Human ICAM-1

Human Fibronectin

Human Hydrocortisone

R&D Systems

Sigma-Aldrich, Co.

PeproTech, inc.

PeproTech, inc.

PeproTech, inc.

PeproTech, inc.

PeproTech, inc.

PeproTech, inc.

Sigma-Aldrich, Co.

Sigma-Aldrich, Co.

Cytokines

Recombinant proteins

(soluble)

Human IFN-γ (Interferon-γ) ;

Human TGF-β (Transforming growth factor beta) ;

Human IL-1-β (interleukin-1β) ;

Human IL-2 (interleukin-2) ;

Human IL-3 (interleukin-3) ;

Human IL-4 (interleukin-4) ;

Human IL-6 (interleukin-6) ;

Human IL-7 (interleukin-7) ;

Human IL-9 (interleukin-9) ;

Human IL-10 (interleukin-10) ;

Human IL-12 (interleukin-12) ;

Human IL-13 (interleukin-13) ;

Human IL-15 (interleukin-15) ;

Human IL-18 (interleukin-18) ;

Human IL-21 (interleukin-21) ;

Human IL-22 (interleukin-22) ;

Human IL-23 (interleukin-23) ;

Human IL-27 (interleukin-27) ;

Human IL-31 (interleukin-31) ;

Human IL-33 (interleukin-33) ;

Human GM-CSF (Granul.-macroph. col. stimul. factor);

Human FLT3-L (FMS-like tyrosine kinase 3 ligand) ;

PeproTech, inc.

PeproTech, inc. PeproTech, inc. PeproTech, inc. PeproTech, inc. PeproTech, inc. Biolegend

PeproTech, inc. PeproTech, inc. PeproTech, inc. PeproTech, inc.

PeproTech, inc.

PeproTech, inc Southern Biotech PeproTech, inc. PeproTech, inc. PeproTech, inc. Biolegend PeproTech, inc.

PeproTech, inc.

PeproTech, inc.

PeproTech, inc.

Table S2. List of reagents tested to optimize the DOT cell production method.

Healthy donor TCRγδ+ PBLs were isolated by MACS and cultured at 1 million cells/ml in 96 well plates, at 37ºC and 5% CO2. Cells were expanded in complete medium (OpTmizer CTS, Thermo Fisher Scientific) supplemented with 5% autologous plasma, 2mM L-glutamine and the above described growth factors. Cells were counted and cell phenotype was analyzed by flow cytometry at the end of the culture period. Fold expansion rate of Vδ1+ T cells was calculated as: (absolute number of Vδ1+ T cells at the end of the culture)/ (absolute number of Vδ1+ T cells at day 0 of culture).

Table S3. Phenotype of healthy donor TCRγδ+ PBLs after two-step MACS protocol

Cell lineage:

B cells

(CD19+ CD20+ cells)

NK cells

(CD56+ CD3- cells)

T cells

(CD3+ cells)

αβ T cells

(TCRαβ+ CD3+ cells)

γδ T cells

(TCRγδ+ CD3+ cells)

Vδ1+ T cells

(TCRVδ1+ CD3+ cells)

Vδ2+ T cells

(TCRVδ2+ CD3+ cells)

Total cell viability

(Trypan Blue- cells)

Donor

A

24.6

9.92

43.5

0.01

41.9

13.5

23.6

79.4

B

6.69

0.07

75.0

0.71

63.2

21.6

30.0

80.1

C

1.36

0.36

95.3

0.37

94.5

1.25

92.6

95.2

D

13.9

6.79

41.2

0.76

40.2

18.3

21.5

89.1

E

17.0

1.84

65.8

2.80

59.6

17.7

40.9

89.9

F

0.28

8.14

91.4

0.81

90.0

2.05

86.1

93.7

G

7.32

0.25

87.5

0.58

81.8

24.0

45.0

84.0

H

3.51

0.10

88.8

0.80

84.8

44.0

27.0

86.0

PBMCs were obtained by density gradient centrifugation in Ficol from buffy coat products collected from 8 healthy donors. TCRγδ+ cells were further isolated by the two-step MACS protocol as described. Cell phenotype was characterized by flow cytometry analysis of cell surface antigens. Data correspond to percentages of total live cells.

Table S4. Phenotype of pre- and post-MACS TCRγδ+ PBLs from CLL patients

Cell lineage:

B cells

(CD19+ CD20+ cells)

NK cells

(CD56+ CD3- cells)

T cells

(CD3+ cells)

αβ T cells

(TCRαβ+ CD3+ cells)

γδ T cells

(TCRγδ+ CD3+ cells)

Vδ1 T cells

(TCRVδ1+ CD3+ cells)

Cell viability

(Trypan Blue- cells)

Donor

Before MACS (Day 0)

CLL-1

63.4

1.22

30.4

27.5

0.66

0.22

92.0

CLL-2

85.7

0.92

8.35

6.97

0.43

0.03

90.0

CLL-3

89.2

0.83

8.22

4.98

2.04

0.02

86.0

CLL-4

41.3

7.61

23.2

12.0

0.81

0.53

89.0

After MACS (Day 0)

CLL-1

38.0

0.72

37.2

0.19

7.32

4.00

88.0

CLL-2

35.4

0.26

61.3

0.05

36.7

1.70

83.0

CLL-3

11.4

0.31

89.0

0.13

88.2

0.70

79.0

CLL-4

30.7

0.43

22.0

0.22

19.7

15.0

85.0

TCRγδ+ T cells were MACS-sorted from the peripheral blood of 4 CLL/SLL patients (CLL-1-4; median age 74.8 years, range 68-83) and were characterized by flow cytometry analysis of cell surface antigens. Shows percentages of TCRγδ+ cells and contaminant cells, obtained immediately before and after the two-step MACS procedure. Data correspond to percentages of total live cells.

Table S5. Phenotype of in vitro expanded TCRγδ+ cells

Cell lineage:

B cells

(CD19+ CD20+ cells)

NK cells

(CD56+ CD3- cells)

T cells

(CD3+ cells)

αβ T cells

(TCRαβ+ CD3+ cells)

γδ T cells

(TCRγδ+ CD3+ cells)

Vδ1+ T cells

(TCRVδ1+ CD3+ cells)

Vδ2+ T cells

(TCRVδ2+ CD3+ cells)

Total cell viability

(Trypan Blue- cells)

Donor

A

0

0.50

99.5

0.01

99.3

82.6

3.9

89.0

B

0

0.02

99.7

0.06

99.5

80.8

3.7

93.3

C

0

0.50

96.3

0.03

92.8

69.9

4.2

90.3

D

0

0.03

99.6

0.02

99.1

62.2

2.3

94.5

E

0

0.11

99.5

0.01

99.2

63.3

3.3

95.9

F

0

0

99.9

0.02

98.0

73.3

4.3

93.2

G

0

0.10

99.4

0.01

98.4

71.7

3.5

90.0

H

0

0.40

97.5

0

98.2

72.0

1.6

89.0

MACS-sorted TCRγδ+ cells from 8 healthy donors (the same as in Table S3) were cultured for 21 days as described. Cell populations were characterized by flow cytometry. Shows percentages of TCRγδ+ T cells and contaminant cells, relative to total live cells present in the cultures.

Table S6. Contaminant autologous B-CLL cells become residual in culture

Cell phenotype after in vitro culture (Day 21)

Cell lineage:

B cells (CD19+ CD20+ cells)

NK cells (CD56+ CD3- cells)

T cells (CD3+ cells)

αβ T cells (TCRαβ+ CD3+ cells)

γδ T cells

(TCRγδ+ CD3+ cells)

Vδ1 T cells

(TCR Vδ1+ CD3+ cells)

NKp30+ Vδ1+ T cells

(pre-gated)

NKG2D+ Vδ1+ T cells

(pre-gated)

Donor

CLL-1

0.03

0.01

99.4

0.04

99.2

65.0

55.6

96.5

CLL-2

0.07

0.45

99.3

0.01

99.3

78.0

36.8

98.1

CLL-3

0.05

0.01

99.8

0.01

99.6

70.1

13.4

97.2

CLL-4

0,04

0.04

99.6

0.01

99.4

64.0

17.8

99.0

TCRγδ+ T cells were MACS-sorted from the peripheral blood of 4 CLL/SLL patients (CLL-1-4; the same as in Table S4) and cultured in vitro for 21 days as previously described. Phenotype was characterized by flow cytometry analysis of cell surface antigens. Shows percentages of TCRγδ+ T cells and contaminant cells. Each cell subset is gated on total live cells, except NKp30 and NKG2D expression that were gated on Vδ1+ T cells.

Table S7. Absolute numbers of Vδ1+ T cells before and after DOT cell culture.

Number of cells:

Peripheral blood samples

Leukapheresis Units

(estimates)

Day 0

Day 21

Day 0

Day 21

CD3+ cells before MACS

CD3+ Vδ1+ cells before MACS

CD3+ Vδ1+ cells after MACS

CD3+ Vδ1+ cells after culture

CD3+ cells before MACS

CD3+ Vδ1+ cells after culture#

Healthy Donors

2.76x108

± 2.07x108

(450ml blood)

2.18x106

± 8.28x105

9.30x105

± 3.90x105

8.12x108

± 2.75x108

≈8x109

(n=6)2

≈ 23x109

CLL Patients

1.15x107

± 6.83x106

(10ml blood)

3.97x104

± 1.38x104

1.01x104

± 7.80x103

1.49x107

± 1.51x107

≈1.4x109

up to 4x109

(n=17)3

≈ 2x109

up to

6x109

TCRγδ+ cells collected from the peripheral blood of 8 healthy donors and 4 CLL patients (the same as in Tables S3-S6) were counted with an haemocytometer and their phenotype was characterized by flow cytometry immediately before and after MACS isolation; and after 21 days of DOT cell culture. Shown are absolute numbers of cells (mean±SD) obtained at each step. On the right, numbers for Leukapheresis products are estimates, starting from available data on healthy donors (2) or CLL patients (3).

Supplemental Figures

Figure S1. TCRγδ+ PBL enrichment after two-step MACS isolation.

Peripheral blood (obtained from buffy coats) was collected from 4 healthy volunteers, and total γδ T cels were isolated by MACS: first, TCRαβ depletion was performed and then CD3+ cells were positively selected. Cells were stained for TCRγδ, CD3 and TCRVδ1 and analyzed by flow cytometry. Dot plots show fractions of TCRγδ+ PBLs before and after each MACS-sorting step (left panels); and initial and final percentages of Vδ1+ T cells (right panels).

(CD28) (CD45RO) (CD49a) (CD9) (CD57) (CD71) (HLA-DR) (CD101) (CD117) (CD148) (CD132) (CD172a) (2B4 ) (CD82) (CD31) (CD161 )

Figure S2. Characterization of the DOT-cell surface phenotype.

This figure complements Fig. 2. Histogram overlays for cell surface markers in DOT cells at day 21 of culture (full line) or ex vivo Vδ1+ T cells (dotted lines), as analyzed using the LEGENDScreen kit for flow cytometry. Data derive from one healthy donor and are representative of four different donors.

Figure S3. Phenotypical and functional analysis of γδ T cell subsets present in the DOT-cell product.

A. Dot plots show cells stained for CD3, TCRVδ1, TCRVδ2 and for a panel of cell surface markers using the LEGENDScreen kit (the same as in Figure 2). FACS-plots and Histogram overlays for cell surface markers at day 0 of culture (upper panel) and at day 21 of culture (bottom panel) are shown. Shows cell markers expressed in gated CD3+ Vδ1+ T cells (full line) and in gated CD3+ Vδ1neg Vδ2neg T cells (dotted lines), as analyzed for flow cytometry. Data derive from one healthy donor. B. FACS plots of cell populations before (upper panel) and after (middle and bottom panels) isolation by flow cytometry. Shows representative data of cells isolated from 3 different donors. C. Cell populations obtained in B. were used in cytotoxicity assays against MEC-1 target cells as described. Shows results of two technical replicates of 3 different donors (mean±SD). D. DOT cells generated from a healthy donor were co-incubated for 3h with two CLL primary cell samples (collected from the peripheral blood of CLL patients and enriched for CD19+ cells), or with autologous healthy PHA-stimulated αβ T cells. A cocktail of blocking antibodies (anti-NKp30, anti-NKp44, anti-CD2 and anti-Vδ1TCR mAb) was added to the indicated samples. Graph shows percentages of dead (Annexin-V+) target cells (Mean+SD) of 3 technical replicates. *p<0.05; **p<0.01; Student’s t-test).

Figure S4. DOT cells inhibit MEC-1 leukemia cell growth in BRG hosts.

A. To assess the behavior and potential efficacy of DOT cells against CLL in vivo, we took advantage of a xenograft model of human CLL previously shown to reproduce several aspects of the disease and employed to demonstrate efficiency of anti-CD23 CAR-T cells. The model relies on the sub-cutaneous injection of MEC-1 cells into Balb/cRag-/-c-/- (BRG) animals. Schematic of the experiment is shown. 1x107 MEC-1 CLL tumor cells or 1x107 DOT cells were used in each inoculation. B. Picture shows an example of luminescence quantification at day 7 after tumor transfer. At this time-point, tumor is too small for Caliper measurement; this pre-quantification according to luminescence allows the seriation of tumor size before ascribing treatment or PBS control. C. Representative DOT cell recovery, gated on total CD45+ (human + mouse) cells from the indicated organs, at 60 hours after transfer of the DOT cell product shown on the left. We were able to recover human Vδ1+ cells early after transfer. In the spleen and bone marrow, DOT cell recovery was vestigial. D. Tumor size as a function of time in animals receiving either DOT cells or PBS. Vertical dotted lines indicate days of treatment. Black line with filled symbols represents mean tumor size in animals receiving PBS (n=8) and green line and open symbols represent mean tumor size in animals receiving DOT cells We observed a reduction in bulk tumor size in DOT-cell-treated animals compared to mock (PBS-injected) controls (n=8) (*p<0.05, Student’s t-test).

Figure S5. DOT cell distribution and persistence in NSG hosts.

This figure complements Fig. 4. A. Schematic of the experiment. Each host received 1x107 MEC-1 CLL tumor cells and either 2x107 or 1x107 (halved dose) DOT cells/transfer. B. Representative DOT cell recovery, gated on total CD45+ (human + mouse) cells from the indicated organs, at 60 hours after transfer of the DOT cell product shown on the left. C. DOT cell recovery, gated on total CD45+ (human + mouse) cells in the liver, at 55 days after transfer of DOT cells, in representative tumor-bearing (left) or tumor-naïve (right) hosts. No DOT cells could be recovered in the other organs analyzed in tumor-naïve animals.

Figure S6. DOT cells limit tumor growth and dissemination in NSG hosts.

This figure complements Fig. 5. A. DOT cells (2x107) were transferred into tumor-bearing hosts, 6 and 11 days (vertical dotted lines) after tumor (MEC-1) inoculation; control animals received PBS. Tumor size was measured and is depicted for each individual host in each group. Black dashed lines: PBS (n=6); Green solid lines: DOT-Cells (n=5). Animals were sacrificed when tumor size was first measured > 1000 mm3. B. Survival curves for the same experiment shown in A (*p<0.05, log-rank (Mantel-Cox) test).

Figure S7. Blood biochemistry analysis of DOT-cell-treated animals.

Blood was collected at the time of necropsy from animals receiving PBS or DOT cells, and biochemical analysis was performed for Alanin-Aminotransferase (ALT/GPT), Aspartate Aminotransferase (AST/GOT), Blood Urea Nitrogen (BUN), Creatinin, Creatin phosphokinase (CPK) and Lactate Dehydrogenase (LDH). Analysis was performed blindly at an independent certified laboratory.

Supplemental References:

1.Tomayko MM, Reynolds CP. Determination of subcutaneous tumor size in athymic (nude) mice. Cancer chemotherapy and pharmacology. 1989;24:148-54.

2.Smetak M, Kimmel B, Birkmann J, Schaefer-Eckart K, Einsele H, Wilhelm M, et al. Clinical-scale single-step CD4(+) and CD8(+) cell depletion for donor innate lymphocyte infusion (DILI). Bone Marrow Transplant. 2008;41:643-50.

3.Hami LS, Green C, Leshinsky N, Markham E, Miller K, Craig S. GMP production and testing of Xcellerated T Cells for the treatment of patients with CLL. Cytotherapy. 2004;6:554-62.

2

A

Measure Tumor (Caliper)

BRG

MEC-1 CLL s.c

Day 0715

DOT-cells or PBSi.vAnalyze all animalswhen first tumorreaches 1000mm

3

12

Homing

10

Lumina

DOTPBSDay 7Assigned to groupsRecovered at 60 Hours

LiverLung

0.2257

1.1

67

Hu-CD3

Hu-CD45Vδ1Hu-CD3TransferredDOT-CellsHu-CD367Vδ1

BCD

1000500

PBSDOT

Tumor Size (mmm

3

)040302010

Days after tumor transfer

****

AB

Hu-CD3

68

Vδ1Hu-CD3Hu-CD45

6.42.150.050.352.1

LiverLungSpleenBone MarrowTumour

6675676043

Vδ1TransferredDOT-Cells

Recovered at 60 Hours Measure Tumor (Caliper)

NSG

MEC-1 CLL s.c

Day 0411

DOT-cells or PBSi.vAnalyze each animalwhen tumorreaches 1000mm

3

6

Lumina

Hu-CD3Mouse-CD45+ Tumor

30

C

− Tumor

AB

1000500

PBSDOTTumor Size (mmm

3

)

0

40302010Days after tumor transfer

1500

5060

50

PBSDOTSurvival (%)

0

40302010Days after tumor transfer

100

5060

*

Depletion of TCRαβ

+

cellsSelection of CD3

+

cellsPBMCs

CD3TCRγδ

4,0312,93,4315,77,980,622,06,6423,593,463,790,7

Donor 1

PBMCs

TCRVδ1

1,760,4914,734,62,110,380,740,09After Selection

Donor 2Donor 3Donor 4