Immunotherapy with interleukin-2 and α-interferon after IL-2-activated hematopoietic stem cell transplantation for breast cancer
| Autor: | M. E. Lippman, Amitabha Mazumder, V Sulica, B Berberian, Kenneth R. Meehan, B Arun, Areman Em, Edmund A. Gehan |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
medicine.medical_specialty Transplantation Conditioning Cyclophosphamide Cell Survival Biopsy medicine.medical_treatment Graft vs Host Disease Breast Neoplasms Hematopoietic stem cell transplantation Neutropenia Gastroenterology chemistry.chemical_compound Internal medicine medicine Humans Skin Transplantation Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Interferon-alpha Hematology Middle Aged medicine.disease Combined Modality Therapy Rash Carboplatin Surgery Treatment Outcome Tolerability chemistry Interleukin-2 Female Immunotherapy medicine.symptom business medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 23:667-673 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1701632 |
| Popis: | We previously demonstrated findings suggestive of autologous GVHD in patients receiving IL-2-activated peripheral blood stem cells (PBSC) with IL-2 after transplantation. A pilot study was designed to test tolerability, feasibility and frequency of autologous GVHD and engraftment using IL-2 and alpha-IFN post-transplantation. After cyclophosphamide (6 g/m2) and carboplatin (1800 mg/m2), patients with high-risk stage II or III breast cancer received chemotherapy and rhG-CSF mobilized autologous PBSC that had been cultured in IL-2 for 24 h. Subcutaneous administration of IL-2 began on day 0 at 6 x 10(5) IU/m2/day for 5 of 7 days each week and continued for 4 weeks. Once engraftment occurred, alpha-IFN was initiated at a dose of 1 x 10(6)/m2/day subcutaneously for 30 days. Thirty-four consecutive patients with stage II (n=20), IIIA (n=6) and IIIB (n=8) disease were treated. All patients were without evidence of disease at the time of transplantation. The average time required for the ANC to reach 500/mm3 was 10 days (range: 8-11 days) and for platelets to reach 20000/mm3 was 10.7 days (range: 6-21 days). Forty-seven percent of patients (n=16) completed the full course of immunotherapy; the remaining patients received attenuated doses due to patient's request (n=6), development of temperature >38 degrees C (n=3), development of neutropenia (n=3), serious infection (n=1) and miscellaneous reasons (n=5). Four patients experienced transient moderate toxicities (level 3) including elevated liver function tests, nausea, rash and capillary leak syndrome. Pathological findings suggestive of skin GVHD developed in 43% of patients (12/28 patients) when skin biopsies were evaluated in a blinded fashion. At 13 months post-transplant (median; range: 5-24 months), 28 patients (82%) remain disease-free. These results demonstrate the feasibility and toxicity of this regimen along with pathological findings compatible with autologous GVHD of the skin. |
| Databáze: | OpenAIRE |
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