Sterile abscesses in glioma patients treated by intraparenchymal injection of lymphokine-activated killer cells and recombinant interleukin-2: case reports.
Sterile abscesses in glioma patients treated by intraparenchymal injection of lymphokine-activated killer cells and recombinant interleukin-2: case reports.
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脑实质内注射淋巴因子激活的杀伤细胞和重组白细胞介素 2 治疗神经胶质瘤患者的无菌脓肿：病例报告。
DOI：
10.1097/00006123-198911000-00019
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发表时间：
1989
期刊：
影响因子：
4.8
通讯作者：
Young,HF
中科院分区：
文献类型：
--
作者：
Atkinson,LL;Merchant,RE;Ghatak,NR;Young,HF
：早些时候，我们进行了I期临床试验，以确定恶性胶质瘤患者瘤内注射表达淋巴因子激活的杀伤细胞(LAK)活性和重组白介素2(rIL-2)的自体淋巴细胞过继免疫治疗的急性毒性。在开颅手术和瘤内注射自体LAK细胞加rIL-2的6周内，29名患者中有3名患者的临床状态和CT和磁共振扫描的证据表明，在以前的手术和免疫治疗的部位有不明性质的水肿和肿块。开颅手术切除脑组织，降低颅内压。切除材料的显微镜检查显示，切除的肿块内没有新的肿瘤生长，而是组织具有慢性无菌脓肿的组织学特征，包括坏死、纤维化和炎细胞涌入。年龄、卡诺夫斯基评分、肿瘤切除程度和免疫状态可能是导致这3名患者出现这种反应的因素。所有3人都接受了高于平均数量的rIL-2激活的淋巴细胞的治疗，这些淋巴细胞在体外显示出显著的LAK活性。结果表明，在临床状况良好且未被皮质类固醇抑制的患者中，LAK细胞联合rIL-2脑实质内免疫治疗胶质瘤的剂量限制性毒性可能与注射的激活细胞的总数和绝对数量有关，这种毒性随着时间的推移而发展，并表现为无菌脓肿的发展。
: Earlier, we conducted Phase I clinical trials to determine any acute toxicity of adoptive immunotherapy with intralesional injections of autologous lymphocytes expressing lymphokine-activated killer (LAK) activity and recombinant interleukin-2 (rIL-2) in patients with malignant glioma. Within six weeks of craniotomy and intralesional injection of autologous LAK cells plus rIL-2, 3 of 29 patients demonstrated a decline in clinical status and evidence on computed tomographic and magnetic resonance imaging scans of edema and mass of unknown character at the site of previous surgery and immunotherapy. Craniotomy was performed to remove the tissue and reduce intracranial pressure. Microscopic examination of the excised material indicated no new tumor growth within the resected mass, but rather that the tissue had the histological characteristics of a chronic sterile abscess including necrosis, fibrosis, and influx of inflammatory cells. Factors that may have contributed to this reaction in the 3 patients were age, Karnofsky score, the extent of tumor excision, and immune status. All 3 had also been treated with greater than average numbers of rIL-2 activated lymphocytes that demonstrated significant in vitro LAK activity. The results suggest that in patients whose clinical status is good and who are not immunosuppressed by corticosteroids, the dose-limiting toxicity of intraparenchymal immunotherapy with LAK cells plus rIL-2 for glioma may be related to the total, absolute number of activated cells injected, and this toxicity develops over time and is manifested by development of a sterile abscess.(Neurosurgery 25: 805-809, 1989)