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@proceedings{759851,
author = {Očadlíková, Darina and Zahradová, Lenka and Kovářová, Lucie and Michálek, Jaroslav and Hájek, Roman},
booktitle = {Haematologica/the hematology journal},
keywords = {Multiple myeloma; Idiotype; Vaccination.},
language = {eng},
title = {The preparation of monoclonal immunoglobulin loaded dendritic cells vaccine for myeloma patients under GMP conditions: preclinical and first clinical results of a phase I/II clinical trial.},
year = {2007}
}
TY - CONF
ID - 759851
AU - Očadlíková, Darina - Zahradová, Lenka - Kovářová, Lucie - Michálek, Jaroslav - Hájek, Roman
PY - 2007
TI - The preparation of monoclonal immunoglobulin loaded dendritic cells vaccine for myeloma patients under GMP conditions: preclinical and first clinical results of a phase I/II clinical trial.
KW - Multiple myeloma
KW - Idiotype
KW - Vaccination.
N2 - Feasibility and safety of vaccination with Id-protein loaded autologous dendritic cells was proved in patients with multiple myeloma under the GMP conditions. Adjuvant immunotherapy with antigen-loaded dendritic cells (DCs) represents a novel and relatively non-toxic treatment modality for multiple myeloma (MM). Malignant cells in MM produce a monoclonal immunoglobulin (idiotypic protein) which is considered a tumor-specific antigen and can be used for the induction of T lymphocytes. To enhance the anti-myeloma immune response, the idiotypic protein (Id-protein) can be loaded into autologous DCs and used for vaccination. Aims: The aim of this study was to evaluate DC-based vaccine preclinically and test the safety and the immune response of the vaccine in patients with MM. Patients and Methods: Pre-clinical testing was performed in 8 patients with MM. DC loaded with autologous myeloma cells were used for autologous T cell stimulation in vitro. After succesful preclinical testing, we have vaccinated 4 patients with stable disease or asymptomatic slow progressive disease according to EBMT criteria. Patients were pre-treated with high-dose chemotherapy and auto-PBSCT. DC precursors were isolated as an adherent fraction from peripheral blood of the myeloma patients. DCs were prepared in vitro and loaded with Id-protein under GMP conditions as previously described (Ocadlikova et al.Med Oncol 2006, 23: 377-384). Patients were vaccinated every 4 weeks subcutaneously with 6 doses, each containing 1,46-18,1 e 06 (mean 9,52 e 06) DCs. The immune response was evaluated by flow cytometry, Elispot and the skin test of hypersensitivity. Results: IFN-gamma production of T cells stimulated with autologous myeloma cell loaded DC was observed. After successful pre-clinical testing a clinical phase I/II trial was initiated. A total of 24 vaccines were applied to 4 patients so far (January 2007). The viability, number and functional characteristics of in vitro matured DCs loaded with Id-protein were satisfactory with 50,10-99,3% (mean 87,08%) of HLADR/CD86+ cells. Each vaccination was well tolerated with only mild fever in 1 patient. No grade II-IV. toxicity appeared. The clinical trial is ongoing and a total of 12 patients is planned to be evaluated. Conclusions: Vaccination with Id-protein loaded autologous dendritic cells demonstrates feasibility and safety in patients with multiple myeloma pre-treated with high dose chemotherapy.
ER -
OČADLÍKOVÁ, Darina, Lenka ZAHRADOVÁ, Lucie KOVÁŘOVÁ, Jaroslav MICHÁLEK and Roman HÁJEK. The preparation of monoclonal immunoglobulin loaded dendritic cells vaccine for myeloma patients under GMP conditions: preclinical and first clinical results of a phase I/II clinical trial. In \textit{Haematologica/the hematology journal}. 2007.
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