Intracavitary placement of autologous lymphokine-activated killer (LAK) cells after resection of recurrent glioblastoma
Intracavitary placement of autologous lymphokine-activated killer (LAK) cells after resection of recurrent glioblastoma
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DOI：
10.1097/00002371-200409000-00009
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发表时间：
2004-09-01
影响因子：
3.9
通讯作者：
Chico, S
中科院分区：
文献类型：
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作者：
Dillman, RO;Duma, CM;Chico, S
本研究旨在获得组织学证实的复发性多形性胶质母细胞瘤（GBM）患者手术后接受局内淋巴因子激活杀手（LAK）细胞治疗的安全性和生存数据。外周血单核细胞与白细胞介素-2体外培养3 ~ 5 d生成LAK细胞。40例手术病理证实为GBM的患者将自体LAK细胞置入肿瘤腔内。23名男性和17名女性的中位年龄为48岁（21-76岁）。从最初诊断为胶质瘤到LAK治疗的中位时间间隔为10.9个月。患者平均接受2.0 +/- 1.0 × 10(9)个LAK细胞，存活率为91 +/- 6.8%。治疗耐受性良好；60天内有一人死亡。中位随访时间为2.3年，lak后中位生存期为9.0个月；1年生存率为34%。性别、年龄、肿瘤位置、LAK细胞裂解活性、植入细胞数量和细胞灌注时白介素-2的掺入与结果无关。31例初诊时患有GBM的患者自最初诊断之日起的中位生存期为17.5个月，而对照组41例当代GBM患者的中位生存期为13.6个月（p(2) = 0.012）。这种治疗是安全可行的。中位生存率高于大多数已发表的复发性GBM再手术患者的报道。需要随机试验来确定治疗效果。
This study was performed to obtain safety and survival data for patients with histologically confirmed recurrent glioblastoma multiforme (GBM) who received intralesional lymphokine-activated killer (LAK) cells following surgery. LAK cells were generated by incubating peripheral blood mononuclear cells with interleukin-2 for 3 to 5 days in vitro. Forty patients with pathologic confirmation of GBM at surgery had placement of autologous LAK cells into the tumor cavity. The 23 men and 17 women had a median age of 48 years (range 21-76). The median interval from the original diagnosis of glioma to LAK treatment was 10.9 months. Patients received an average of 2.0 +/- 1.0 x 10(9) LAK cells, with viability of 91 +/- 6.8%. Treatment was well tolerated; there was one death within 60 days. At a median follow-up of 2.3 years, median survival post-LAK was 9.0 months; 1-year survival was 34%. Gender, age, location of tumor, LAK cell lytic activity, number of cells implanted, and inclusion of interleukin-2 at cell instillation were not correlated with outcome. Median survival from the date of original diagnosis for 31 patients who had GBM at initial diagnosis was 17.5 months versus 13.6 months for a control group of 41 contemporary GBM patients (p(2) = 0.012). This treatment is safe and feasible. The median survival rates are higher than reported in most published series of patients who underwent reoperation for recurrent GBM. A randomized trial would be needed to establish therapeutic benefit.