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Cord blood-derived natural killer (cbNK) cells are an investigational allogeneic cell therapy consisting of natural killer (NK) cells isolated from umbilical cord blood, expanded ex vivo, and typically activated with cytokines such as IL-2 or IL-15. Unlike autologous T-cell therapies, cbNK cells do not require HLA matching and carry a minimal risk of graft-versus-host disease (GvHD), facilitating their use as an "off-the-shelf" therapeutic. The mechanism of action involves the innate ability of NK cells to identify and eliminate malignant cells through a balance of activating and inhibitory signals. Key activating receptors include NKG2D and the natural cytotoxicity receptors (NKp30, NKp44, NKp46), which recognize stress-induced ligands on tumor cells. Additionally, cbNK cells express CD16 (FcγRIIIa), enabling them to mediate antibody-dependent cellular cytotoxicity (ADCC) when combined with tumor-targeting monoclonal antibodies. Upon activation, these cells release cytotoxic granules containing perforin and granzymes to induce apoptosis in target cells. This platform is being extensively studied for hematologic malignancies, both as a monotherapy and in combination with engagers like AFM13.
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