SUCCESSFUL COMBINED IMMUNOTHERAPY OF MALIGNANT GLIOMAS OF CENTRAL
NERVOUS SYSTEM IN CHILDREN AND ADOLESCENTS
Abstract
The incidence of high-grade malignant gliomas (MG) ranges from 35 to
46% of all central nervous system tumors. Despite combined therapy
including surgery, radiation and chemotherapy overall five-year survival
does not exceed 10%. Our study included 9 patients, median age 10 years
(2-19). 3 pts had anaplastic astrocytoma (AA), 4 pts had glioblastoma
multiforme (GBM) and 2 pts had diffuse brainstem glioma (BSG). The
median time to the first relapse was 12 months, to the second one– 5
months. The protocol of immunotherapy included combined administration
of autologous dendritic cell-based vaccine (DV) and repeated
intrathecal/intraventricular injections of donor allogenic
immunocompetent cells (alloIC) for at least 2 years. Four of 9 pts are
alive and well 82, 23, 71 and 67 months after the immunotherapy start (2
pts with GBM in the 3rd and 2nd relapse, and 2 pts with AA in the 1st
relapse and 2nd, respectively). Three of them are in CR proved by PET
with 11C methionine and free of any therapy for more than 15 months. One
pt with 2nd relapse of metastatic GBM is currently in SD status and on
immunotherapy for 23 months. Five pts died from disease progression
within 2 – 4 months from the start of immunotherapy. Over the period of
treatment the pts received a median of 19 (4 to 60) alloIC injections
and 16 (2 to 44) DV administrations. Immunotherapy could be an
attractive option for treating patients with gliomas irresponsible to
conventional therapy and is worthy of further investigation.