rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2410-1893-2022-9-4-2rpmj-794Research ArticleОригинальные статьи. Онкология, лучевая терапияOriginal Articles. ОncologyОпыт применения дендритных вакцин в лечении пациентов с рецидивными глиомамиExperience in the use of dendritic vaccines in the treatment of patients with recurrent gliomashttps://orcid.org/0000-0002-8398-7001РыковМ. Ю.RykovM. Yu.

Рыков Максим Юрьевич – доктор медицинских наук, доцент, заведующий кафедрой онкологии, гематологии и лучевой терапии

129226, Москва, ул. Вильгельма Пика, д. 4

SPIN: 7652-0122,

AuthorID: 724128,

ResearcherID: R-9768-2016,

Scopus Author ID: 57190262153

Maksim Yu. Rykov – Dr. Sci. (Med.), associate professor, head of the department of oncology, hematology and radiology

4 Vilgelma Pika str., Moscow 129226

SPIN: 7652-0122,

AuthorID: 724128

ResearcherID: R-9768-2016

Scopus Author ID: 57190262153

wordex2006@rambler.ruhttps://orcid.org/0000-0001-9777-1220ДолгополовИ. С.DolgopolovI. S.

Долгополов Игорь Станиславович – доктор медицинских наук, заведующий кафедрой педиатрии педиатрического факультета

Тверь

SPIN: 4312-9786,

AuthorID: 129840

Igor S. Dolgopolov – Dr. Sci. (Med.), head of the department of pediatrics, pediatric faculty

Tver

SPIN: 4312-9786,

AuthorID: 129840

Российский государственный социальный университетРоссияRussian State Social UniversityRussian FederationТверской ГМУRussian FederationTver State Medical UniversityRussian Federation202201122022941829Copyright © Рыков М.Ю., Долгополов И.С., 20222022Рыков М.Ю., Долгополов И.С.Rykov M.Y., Dolgopolov I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/794Цель исследования

Цель исследования. Обосновать целесообразность клеточной иммунотерапии при лечении пациентов с рецидивами глиом высокой степени злокачественности и оценить безопасность инъекций аллогенных клеток непосредственно в спинномозговую жидкость.

Материалы и методы

Материалы и методы. В исследование включены 5 пациентов в возрасте от 2 до 16 лет. У трех пациентов диагностирована анапластическая астроцитома (AA), у одного пациента –мультиформная глиобластома (МГ) (3‑й рецидив), и еще у одного пациента – диффузная глиома ствола мозга (ДГ). Среднее время до развития первого рецидива составило 12 мес. (от 4 до 16 мес.), до развития второго – 5 мес. (от 1 до 8 мес.). Протокол иммунотерапии включал комбинированное введение аутологичной вакцины на основе дендритных клеток (ДВ) и повторные интратекальные / внутрижелудочковые инъекции донорских аллогенных иммунокомпетентных клеток в течение не менее 2 лет.

Результаты

Результаты. У двух из трех пациентов с АА интервал без прогрессирования составил 67 и 71 мес. Один пациент с третьим рецидивом МГ жив без какой-либо терапии через 13,3 года после начала иммунотерапии. Среднее время наблюдения составило 67 мес., общая двухлетняя выживаемость составила 58 %. Два пациента умерли от прогрессирования заболевания в течение 6 и 7 мес. от начала иммунотерапии. За период лечения пациенты получали в среднем 20 (от 8 до 60) инъекций аллогенных иммунокомпетентных клеток и 18 (от 8 до 44) инъекций ДВ. Побочных эффектов не наблюдалось.

Заключение

Заключение. Иммунотерапия может быть привлекательным вариантом для лечения пациентов со злокачественными глиомами высокой степени злокачественности, не поддающимися традиционной терапии, и заслуживает дальнейшего изучения.

Purpose of the study

Purpose of the study. To substantiate the expediency of cellular immunotherapy in the treatment of patients with relapses of high-grade gliomas and evaluate the safety of injecting allogeneic cells directly into the cerebrospinal fluid.

Materials and methods

Materials and methods. Our study included 5 patients, median age 7,6 years (2–16). Three patients had anaplastic astrocytoma (AA) (1st recurrence – 1 patient, 2nd recurrence – 2 patients), 1 patient had glioblastoma multiforme (GBM) (3rd recurrence) and 1 had diffuse brainstem glioma (BSG). The median time to the first relapse was 12 months (4 to 16), to the second one was 5 months (1 to 8). 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.

Results

Results. Two of 3 patients with AA experienced a progression-free interval of 67 and 71 months One patient with 3rd GBM relapse is alive without any therapy 13.3 years after immunotherapy start. The median time of follow-up was 67 months with the 2‑years overall survival was 58 %. Two patients died from disease progression within 6 and 7 months from the start of immunotherapy. Over the period of treatment the patients received a median of 20 (8 to 60) alloIC injections and 18 (8 to 44) DV administrations. No serious side-effect was observed.

Conclusion

Conclusion. Immunotherapy could be an attractive option for treating patients with high-grade malignant gliomas irresponsible to conventional therapy and is worthy of further investigation.

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The authors declare that there are no conflicts of interest present.