IMMUNOTHERAPY FOR CHILDREN WITH MALIGNANT BRAIN TUMORS



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Abstract

Abstract

Background. 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%. The emergence of novel immunotherapeutic strategies has cultivated a renewed optimism for the treatment of MG.

Aim. Improving the survival rate of patients with gliomas.

Materials and methods. Our study included 5 patients, median age 7,6 years (2-16). Three pts had anaplastic astrocytoma (AA) (1st recurrence – 1 pt, 2nd recurrence – 2 pts), 1 pt had glioblastoma multiforme (GBM) (3rd recurrence) and 1 pt had diffuse brainstem glioma (BSG). The median time to the first relapse was 12 months (4 to 16), to the second one– 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. Two of 3 pts with AA experienced a progression-free interval of 67 and 71 months One pt. 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 pts died from disease progression within 6 and 7 months from the start of immunotherapy. Over the period of treatment the pts received a median of 20 (8 to 60) alloIC injections and 18 (8 to 44) DV administrations. No serious side-effect was observed.

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.

About the authors

Igor Stanislavovich Dolgopolov

Tver State Medical University, 170100, Tver, Russian Federation;
Children's Regional Clinical Hospital, 170100, Tver, Russian Federation

Email: irdolg@rambler.ru
ORCID iD: 0000-0001-9777-1220

Head of the Department of Pediatrics, Pediatric Faculty, Tver State Medical University

Russian Federation, Tver State Medical University, 170100, Tver, Russian Federation; Children's Regional Clinical Hospital, 170100, Tver, Russian Federation

Maxim Yurievich Rykov

Russian State Social University, 129226, Moscow, Russian Federation

Author for correspondence.
Email: wordex2006@rambler.ru
ORCID iD: 0000-0002-8398-7001

Doctor of Medical Sciences, Associate Professor, Head of the Department of Pediatric, Russian State Social University

Russian Federation, Russian State Social University, 129226, Moscow, Russian Federation

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