Isolation perfusion in extracorporeal circulation with interleukin-2 and lymphokine-activated killer cells in the treatment of in-transit metastases from limb cutaneous melanoma |
| |
Authors: | Dr Maurizio Vaglini MD Dr Filiberto Belli MD Mario Santinami MD Flavio Arienti MD Giorgio Parmiani MD Laura Persiani MD Nicola Santoro MD Maria Grazia Inglese MD Fortunato D'Elia MD Natale Cascinelli MD |
| |
Institution: | (1) the Department of Experimental Oncology D, Istituto Nazionale Tumori, Milan, Italy;(2) From the Department of Anaesthesiology and Intensive Care Unit, Istituto Nazionale Tumori, Milan, Italy;(3) Department of Surgical Oncology B, Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy |
| |
Abstract: | Background: Therapies of advanced melanoma patients with interleukin-2 (IL-2) and cytotoxic lymphocytes have produced interesting results, but a larger diffusion of these treatments is limited by the severe side effects due to IL-2 systemic infusion. A strictly regional administration of IL-2 and cells by an isolation perfusion (IP) in extracorporeal circulation (ECC) for the treatment of regional melanoma metastases could improve tolerability and efficacy of this specific modality of immunotherapy.
Methods: Ten patients were submitted to adoptive immunotherapy with IL-2 and lymphokine-activated killer (LAK) cells by IP in ECC. The schedule of treatment included the first course of a 5-day systemic administration of IL-2 (Proleukin, EuroCetus 9–12 × 106 IU/M2/day continuous infusion); autologous LAK cells were obtained via leukapheresis and after in vitro activation were given (range 8–28 × 109) along with IL-2 (120-2,400 IU/ml of perfusion priming) to the affected limb by IP; IL-2 (9–12×106 IU/m2/day) was also administered by systemic continuous infusion for 5 days starting on the day after IP.
Results: All patients concluded the treatment without any major local or systemic toxicities. Clinical responses included one complete and six partial remissions; three patients had stable disease. All patients are alive. Follow-up after IP ranged from 12 to 35 months (median: 22). The analysis of circulating lymphocytes revealed the rapid disappearance of LAK cells, suggesting their extravasation and/or endothelial adhesion in perfused tissues.
Conclusions: IP with IL-2 and LAK cells is a new approach for the treatment of in-transit metastases due to cutaneous melanoma. The treatment appears to be feasible and reliable. Further biological and immunological studies should permit amelioration of the present modality of treatment. |
| |
Keywords: | Isolation perfusion Melanoma Interleukin-2 Immunotherapy Lymphokine-activated killer cells |
本文献已被 SpringerLink 等数据库收录! |
|