Reinfusion of Autologous Lymphocytes With Granulocyte-Macrophage Colony-Stimulating Factor Induces Rapid Recovery of CD4+ and CD8+ T Cells After High-Dose Chemotherapy for Metastatic Breast Cancer
| Autor: | G C, de Gast, F A, Vyth-Dreese, W, Nooijen, C J C, van den Bogaard, J, Sein, M M J, Holtkamp, G A M, Linthorst, J W, Baars, J H, Schornagel, S, Rodenhuis |
|---|---|
| Přispěvatelé: | Other departments |
| Rok vydání: | 2002 |
| Předmět: |
Adult
CD4-Positive T-Lymphocytes Cancer Research Breast Neoplasms CD8-Positive T-Lymphocytes Middle Aged Combined Modality Therapy Recombinant Proteins Statistics Nonparametric Blood Transfusion Autologous Oncology Lymphocyte Transfusion Antineoplastic Combined Chemotherapy Protocols Granulocyte Colony-Stimulating Factor Humans Interleukin-2 Female Neoplasm Metastasis |
| Zdroj: | Journal of clinical oncology, 20(1), 58-64. American Society of Clinical Oncology |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2002.20.1.58 |
| Popis: | PURPOSE: Repeated high-dose chemotherapy (HDCT) followed by peripheral-blood progenitor cell (PBPC) transplantation can induce a complete remission in patients with metastatic breast cancer sensitive to standard chemotherapy (CT), but the majority of patients relapse within 1 to 2 years. The immune system is seriously compromised after HDCT, which precludes the development of effective immunotherapy. We investigated whether autologous lymphocytes, reinfused after HDCT, could induce a rapid recovery of T cells. PATIENTS AND METHODS: Three patients were monitored for immune recovery without reinfusion of lymphocytes. In the next 11 patients, stem cells were harvested after CT + granulocyte colony-stimulating factor (G-CSF) and lymphocytes were harvested after CT + granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-2. These patients received stem cells and G-CSF after the first HDCT; stem cells, G-CSF, and lymphocytes after the second; and stem cells, GM-CSF, and lymphocytes after the third HDCT. RESULTS: Patients not receiving lymphocyte reinfusion had a very slow recovery of lymphocytes. In particular, CD4 counts remained low (< 200/μL for 9 months). Lymphocyte reinfusion had a significant effect on the recovery of lymphocytes, T cells, and CD8+ T cells (normalized on day 25). Recovery of CD4+ T cells was significantly accelerated by lymphocyte reinfusion and GM-CSF, leading to counts of 500/μL at 25 days. CONCLUSION: Lymphocyte reinfusion with G-CSF had a significant effect on the recovery of CD8+ T cells, whereas rapid recovery of CD4+ T cells required lymphocyte reinfusion and GM-CSF, which possibly acts as a survival factor through activation of antigen presenting cells. Whether the rapid recovery of CD4+ and CD8+ T cells prevents or delays relapse of the disease should be further investigated. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|