Adoptive cellular immunotherapy for refractory childhood cancers: a single center experience
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Michael Merker1, Michael Torsten Meister1,2, Annekathrin Heinze1, Andrea Jarisch1, Jan Sörensen1, Sabine Huenecke1, Melanie Bremm1, Claudia Cappel1, Thomas Klingebiel1, Peter Bader1 and Eva Rettinger1
1 Division of Stem Cell Transplantation and Immunology, Department of Children and Adolescent Medicine, University Hospital Frankfurt, JW Goethe University, Frankfurt am Main, Germany
2 Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
Keywords: adoptive cellular immunotherapy; allogeneic; solid tumors; childhood; HSCT
Received: May 06, 2019 Accepted: September 10, 2019 Published: October 22, 2019
Prognosis of refractory childhood cancers despite multimodal treatment strategies remains poor. Here, we report a single center experience encountered in 18 patients with refractory solid malignancies treated with adoptive cellular immunotherapy (ACI) from haploidentical or matched donors following hematopoietic stem cell transplantation. While seven patients were in partial and six in complete remission (CR), five patients suffered from relapsed diseases at the time of ACI. 1.5-year probabilities of overall survival (OS) and progression-free survival (PFS) were 19.5% and 16.1% for all patients. Patients in CR showed estimated 1.5-year OS and PFS of 50.1% and 42.7%, respectively. CR was induced or rather sustained in ten children, with two still being alive 9.6 and 9.3 years after ACI. Naïve, central and effector memory T-cells correlated with responses. However, the majority of patients relapsed. Cumulative incidence of relapse was 79.8% at 1.5 years. Acute graft versus host disease (aGVHD) occurred in nine of 18 patients (50%) with aGVHD grade I–II observed in six (33%) and aGVHD grade III seen in three (17%) patients, manageable in all cases.
Altogether, study results indicate that donor-derived ACI at its current state offers palliation but no clear curative benefit for refractory childhood cancers and warrants further improvement.
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