Adjuvant Dendritic Cell-Based Tumour Vaccination for Children With Malignant Brain Tumours

Background. A large experience with dendritic cell (DC)-based vaccination for malignant brain tumours has been gained in adults Here we focus on the results obtained in children with relapsed malignant brain tumours Procedure. In total 45 children were vaccinated 33 high grade glioma (HGG), 5 medulloblastoma (MB)/primitive neuro-ectodermal tumour (PNET), 4 ependymoma and 3 atypical teratoid-rhabdoid tumour (ATRT) Autologous, monocyte-derived DC were generated and loaded with tumour lysate, which was used as source of tumour-associated antigens Results. In 38 patients peripheral blood mononuclear cells (PBMC) were obtained from leukapheresis and in 7 patients from fresh blood samples 7 HGG patients are still alive with median follow-up(FU) of 35.7 months (range 12.1-85.6) Median overall survival (OS) was 13.5 months (range 1.4-85.6) All patients with MB/PNET died (median OS 5.7 months, range 4.3-51.2) One patient with ependymoma is still alive at 22.3 months FU The other three patients died at, respectively, 7.7, 30.1 and 31.5 months Two patients with ATRT are still alive at, respectively, 34.1 and 52.6 months FU The third patient died at 50.5 months NO severe adverse events were noticed Conclusions. In this exploratory study, HGG and ATRT seem to respond favourably to vaccination than MB/PNET and ependymoma Although preliminary, our results are promising and support further testing of DC-based immunotherapy in new treatment protocols for HGG and ATRT Pediatr Blood Cancel 2010,54 519-525 (C) 2009 Wiley-Liss, Inc