These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Activity of interleukin-2 in non-Hodgkin's lymphoma following transplantation of interleukin-2-activated autologous bone marrow or stem cells.
    Author: van Besien K, Margolin K, Champlin R, Forman S.
    Journal: Cancer J Sci Am; 1997 Dec; 3 Suppl 1():S54-8. PubMed ID: 9457395.
    Abstract:
    PURPOSE: Disease recurrence constitutes the major cause of treatment failure following autologous transplantation for non-Hodgkin's lymphoma (NHL). Preclinical models indicate that bone marrow or stem cells that have been exposed to recombinant interleukin-2 (rIL-2) can be immunologically purged of chemotherapy-resistant malignant cells while retaining their proliferative potential. Continued treatment with rIL-2 in the posttransplantation period may further enhance the antitumor effect. We review here a phase I clinical study conducted to address the feasibility of this immunotherapeutic approach for reducing the relapse rate following autologous transplantation. PATIENTS AND METHODS: We have performed a phase I clinical trial of rIL-2-treated autologous bone marrow or stem cell transplantation for patients who had hematologic malignancies with poor prognoses. Conditioning for lymphoma patients consisted of thiotepa (250 mg/m2/day x 3 days), busulfan (1 mg/kg orally every 6 hours for 3 days), and cyclophosphamide (60 mg/kg/day x 2 days). Autologous bone marrow or granulocyte colony-stimulating factor (G-CSF) -mobilized autologous stem cells were thawed and exposed for 24 hours to rIL-2 (6000 IU/mL). Posttransplantation rIL-2 therapy (1-2 MIU/m2/day) was administered by continuous infusion from day 1 for a minimum of 21 days. Subsequently, all patients were to receive six cycles of maintenance rIL-2 (6 MIU/m2/day) for 5 days per week in weeks 1 and 2 every 28 days. Patients also received G-CSF (5 micrograms/kg) from day 1 until neutrophil recovery. Twenty-eight patients were accrued, of whom 19 had recurrent or refractory NHL. The median age of NHL patients was 33 years (range, 17-48 years). Seventeen patients had intermediate-grade lymphoma and two had high-grade lymphoma. Five patients received bone marrow, 10 patients received peripheral blood stem cells (PBSC), and four patients received a combination of PBSC and bone marrow. RESULTS: All patients engrafted. The median time to reach a granulocyte count of 0.5 x 10(9) cells/L was 11 days (range, 8-41 days). The median time to reach a platelet count of 50 x 10(9) cells/L was 34 days (range, 9-242 days). The most common dose-limiting toxicities associated with posttransplantation and maintenance rIL-2 therapy were fever, fatigue, and nausea. Among 19 NHL patients, eight patients have developed progressive disease and two patients have died from bilateral pneumonia or radiation-induced cardiomyopathy. Nine patients (47%) remain disease free with a median follow-up of 225 days (range, 150-948 days). CONCLUSION: These data indicate the feasibility of transplanting rIL-2-activated bone marrow or stem cells followed by posttransplantation immunotherapy in patients with advanced NHL. The potential antitumor efficacy of this approach is undergoing further evaluation in a prospective phase II trial.
    [Abstract] [Full Text] [Related] [New Search]