Early recovery of aggressive cytotoxic cells and improved immune resurgence with post-transplant immunotherapy for multiple myeloma.

Abstract:

:A phase I/II trial evaluated early administration and dose escalation of interleukin (IL)-2 with granulocyte macrophage colony stimulating factor (GM-CSF) post-transplant. Following melphalan (200 mg/m(2)) and an autologous transplant, IL-2 was initiated (day 0) and continued for 4 weeks. GM-CSF (250 mcg/m(2)/day) began on day 5. Fifteen of 19 patients completed therapy. No treatment-related deaths occurred. IL-2 (1 x 10(6) IU/m(2)/day) was not tolerated in two of six patients due to > or =grade 3 fatigue/diarrhea (n=1) or supraventricular tachycardia (n=1). The maximum tolerated dose of IL-2 was 6 x 10(5) IU/m(2)/day; this dose was well tolerated by 11 of 13 patients. Neutrophil and platelet engraftment occurred on day 13 (median; range 10-17 days) and day 13 (median; range 0-74 days), respectively. When compared to control patients, there was a marked increase in the number of CD3+ T cells (P=0.005), CD4+ T cells (P=0.01), CD8+ T cells (P=0.001) and CD4+CD25+Treg cells (P=0.015) post-transplant. Cytotoxicity directed against myeloma cells was markedly increased when compared to control patients (P=0.017). This unique trial design using early administration of IL-2 with GM-CSF during the period of lymphodepletion, demonstrated a marked increase in the number and function of early cytotoxic effector T cells, without suppression of engraftment.

journal_name

Bone Marrow Transplant

authors

Meehan KR,Wu J,Bengtson E,Hill J,Ely P,Szczepiorkowski Z,Kendall M,Ernstoff MS

doi

10.1038/sj.bmt.1705665

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

695-703

issue

11

eissn

0268-3369

issn

1476-5365

pii

1705665

journal_volume

39

pub_type

杂志文章
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    authors: Quabeck K

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    authors: Boqué C,Petit J,Sarrá J,Cancelas JA,Muñoz J,Español JI,de la Banda E,Aventin A,Berlanga J,Ferrá C,Amill B,Torrico C,Azqueta C,Llucià M,García J,Grañena A

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    authors: Myers SE,Mick R,Williams SF

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  • Phase I trial of high-dose melphalan, high-dose etoposide and autologous bone marrow re-infusion in solid tumors: an Eastern Cooperative Oncology Group (ECOG) study.

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    journal_title:Bone marrow transplantation

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    doi:

    authors: Lazarus HM,Gray R,Ciobanu N,Winter J,Weiner RS

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    doi:

    authors: Reiffers J,Goldman J,Meloni G,Cahn JY,Faberes C,Apperley J

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Vellodi A,Cragg H,Winchester B,Young E,Young J,Downie CJ,Hoare RD,Stocks R,Banerjee GK

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    doi:10.1038/sj.bmt.1701022

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    更新日期:1997-12-01 00:00:00

  • Allogeneic hematopoietic cell transplantation for myelofibrosis in patients pretreated with the JAK1 and JAK2 inhibitor ruxolitinib.

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