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Sequential intranodal immunotherapy induces antitumor immunity and correlated regression of disseminated follicular lymphoma.

Authors :
Kolstad A
Kumari S
Walczak M
Madsbu U
Hagtvedt T
Bogsrud TV
Kvalheim G
Holte H
Aurlien E
Delabie J
Tierens A
Olweus J
Source :
Blood [Blood] 2015 Jan 01; Vol. 125 (1), pp. 82-9. Date of Electronic Publication: 2014 Oct 07.
Publication Year :
2015

Abstract

Advanced stage follicular lymphoma (FL) is incurable by conventional therapies. In the present pilot clinical trial, we explored the efficacy and immunogenicity of a novel in situ immunotherapeutic strategy. Fourteen patients with untreated or relapsed stage III/IV FL were included and received local radiotherapy to solitary lymphoma nodes and intranodal injections of low-dose rituximab (5 mg), immature autologous dendritic cells, and granulocyte-macrophage colony-stimulating factor at the same site. The treatment was repeated 3 times targeting different lymphoma nodes. Primary end points were clinical responses and induction of systemic immunity. Five out of 14 patients (36%) displayed objective clinical responses, including 1 patient with cutaneous FL who showed regression of skin lesions. Two of the patients had durable complete remissions. Notably, the magnitude of vaccination-induced systemic CD8 T-cell-mediated responses correlated closely with reduction in total tumor area (r = 0.71, P = .006), and immune responders showed prolonged time to next treatment. Clinical responders did not have a lower tumor burden than nonresponders pretreatment, suggesting that the T cells could eliminate large tumor masses once immune responses were induced. In conclusion, the combined use of 3 treatment modalities, and in situ administration in single lymphoma nodes, mediated systemic T-cell immunity accompanied by regression of disseminated FL. The trial was registered at www.clinicaltrials.gov as #NCT01926639.<br /> (© 2015 by The American Society of Hematology.)

Details

Language :
English
ISSN :
1528-0020
Volume :
125
Issue :
1
Database :
MEDLINE
Journal :
Blood
Publication Type :
Academic Journal
Accession number :
25293773
Full Text :
https://doi.org/10.1182/blood-2014-07-592162