Katakura Ryuichi, Suzuki Youichi, Sekine Teruaki, Sasaki Yu F, Fujimiya Yoshiaki
Department of Neurosurgery, Miyagi Cancer Center Hospital, Natori, Japan.
Case Rep Oncol. 2010 Apr 28;3(2):110-124. doi: 10.1159/000313629.
Glioblastoma multiforme (GBM), which occurs mostly in individuals over the age of 40, accounts for 12-15% of all primary brain tumors. Patients with GBM have a poor prognosis, even after aggressive upfront therapies. The present study documents that in 5 of these patients, the use of a novel immunotherapeutic approach combined with standard initial therapies resulted in a prolonged survival of over 3 years, which is significantly longer than the expected survival time with conventional therapies. During the course of intravenous cell-transfer immunotherapy, axial magnetic resonance images of the tumor region were monitored for over 5 years. The discontinuation of adoptive transfer regimens resulted in the rapid deterioration of patients with development of Gd-enhancing regions, indicating the initiation of tumor recurrence. Among patients with recurrence, the reinstatement of adoptive cell regimens with more frequent cell-transfers resulted in an apparent re-regression of tumors. Significantly longer survival times were seen in patients receiving transferred autologous lymphoid cells which were expanded in vitro, and which had a considerable proportion of gammadeltaT cells. We conclude that immunotherapy, combined with standard treatment, plays a significant role in the management of GBM patients and provides patients with a better prognosis.
多形性胶质母细胞瘤(GBM)主要发生在40岁以上的人群中,占所有原发性脑肿瘤的12% - 15%。GBM患者预后较差,即使经过积极的初始治疗也是如此。本研究记录了在其中5例患者中,使用一种新型免疫治疗方法联合标准初始治疗导致生存期延长超过3年,这明显长于传统治疗的预期生存时间。在静脉细胞转移免疫治疗过程中,对肿瘤区域的轴向磁共振图像进行了5年多的监测。过继性转移方案的中断导致患者病情迅速恶化,出现钆增强区域,表明肿瘤复发开始。在复发患者中,更频繁细胞转移的过继性细胞方案的恢复导致肿瘤明显再次消退。在接受体外扩增的自体淋巴细胞转移且其中γδT细胞比例相当大的患者中,观察到生存期明显更长。我们得出结论,免疫治疗联合标准治疗在GBM患者的管理中发挥着重要作用,并为患者提供了更好的预后。