SEARCH:   Advanced

Blood, 27 August 2009, Vol. 114, No. 9, pp. 1736-1745. Prepublished online as a Blood First Edition Paper on June 25, 2009; DOI 10.1182/blood-2009-02-205278. This Article Full Text Full Text (PDF) Supplemental Methods, Table, and Figure All Versions of this Article: blood-2009-02-205278v1 114/9/1736    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Borrello, I. M. Articles by Hege, K. M. PubMed PubMed Citation Articles by Borrello, I. M. Articles by Hege, K. M. Related Collections Immunobiology Transplantation Free Research Articles Myeloid Neoplasia Clinical Trials and Observations Gene Therapy Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Granulocyte-macrophage colony-stimulating factor (GM-CSF)–secreting cellular immunotherapy in combination with autologous stem cell transplantation (ASCT) as postremission therapy for acute myeloid leukemia (AML) Ivan M. Borrello1,*, Hyam I. Levitsky1,*, Wendy Stock2, Dorie Sher2, Lu Qin1, Daniel J. DeAngelo3, Edwin P. Alyea3, Richard M. Stone3, Lloyd E. Damon4, Charles A. Linker4, Daniel J. Maslyar5, and Kristen M. Hege5 1 The Johns Hopkins University, Baltimore, MD; 2 University of Chicago, IL; 3 Dana-Farber Cancer Institute, Boston, MA; 4 University of California, San Francisco; and 5 Cell Genesys, South San Francisco, CA Preclinical models have demonstrated the efficacy of granulocyte-macrophage colony-stimulating factor-secreting cancer immunotherapies (GVAX platform) accompanied by immunotherapy-primed lymphocytes after autologous stem cell transplantation in hematologic malignancies. We conducted a phase 2 study of this combination in adult patients with acute myeloid leukemia. Immunotherapy consisted of autologous leukemia cells admixed with granulocyte-macrophage colony-stimulating factor-secreting K562 cells. "Primed" lymphocytes were collected after a single pretransplantation dose of immunotherapy and reinfused with the stem cell graft. Fifty-four subjects were enrolled; 46 (85%) achieved a complete remission, and 28 (52%) received the pretransplantation immunotherapy. For all patients who achieved complete remission, the 3-year relapse-free survival (RFS) rate was 47.4% and overall survival was 57.4%. For the 28 immunotherapy-treated patients, the RFS and overall survival rates were 61.8% and 73.4%, respectively. Posttreatment induction of delayed-type hypersensitivity reactions to autologous leukemia cells was associated with longer 3-year RFS rate (100% vs 48%). Minimal residual disease was monitored by quantitative analysis of Wilms tumor-1 (WT1), a leukemia-associated gene. A decrease in WT1 transcripts in blood was noted in 69% of patients after the first immunotherapy dose and was also associated with longer 3-year RFS (61% vs 0%). In conclusion, immunotherapy in combination with primed lymphocytes and autologous stem cell transplantation shows encouraging signals of potential activity in acute myeloid leukemia (ClinicalTrials.gov: NCT00116467 [ClinicalTrials.gov] ). CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

	Copyright © 2009 by American Society of Hematology         Online ISSN: 1528-0020