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Long-term IL-2 therapy after transplantation of T cell depleted stem cells from alternative donors in children

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The aim of this pilot study was to evaluate the feasibility of long-term subcutaneous application of low-dose IL-2 in children with malignancies at very high risk of relapse who underwent highly T cell and B cell depleted HLA-identical (MUD) or full haplotype mismatched related hematopoetic stem cel...

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Main Authors: Schlegel, Patrick (Author) , Teltschik, Heiko-Manuel (Author) , Pfeiffer, Matthias (Author) , Handgretinger, Rupert (Author) , Schumm, Michael (Author) , Koscielniak, Ewa (Author) , Feuchtinger, Tobias (Author) , Klingebiel, Thomas (Author) , Bader, Peter (Author) , Schlegel, Paul-Gerhardt (Author) , Greil, Johann (Author) , Lang, Peter (Author)
Format: Article (Journal)
Language:English
Published: 25 June 2011
In: Best practice & research
Year: 2011, Volume: 24, Issue: 3, Pages: 443-452
ISSN:1532-1924
DOI:10.1016/j.beha.2011.04.007
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.beha.2011.04.007
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1521692611000430
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Author Notes:Patrick Schlegel, Heiko-Manuel Teltschik, Matthias Pfeiffer, Rupert Handgretinger, Michael Schumm, Ewa Koscielniak, Tobias Feuchtinger, Thomas Klingebiel, Peter Bader, Paul-Gerhard Schlegel, Johann Greil, Peter Lang
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Summary:The aim of this pilot study was to evaluate the feasibility of long-term subcutaneous application of low-dose IL-2 in children with malignancies at very high risk of relapse who underwent highly T cell and B cell depleted HLA-identical (MUD) or full haplotype mismatched related hematopoetic stem cell transplantation. We studied 11 patients with acute leukemias/myelodysplastic syndrome and juvenile myelomonocytic leukemia (active disease and/or second stem cell transplantation, n = 8; ≥CR 2, n = 2) and relapsed or progressive Ewings sarcoma (n = 2) who received prophylactic IL-2 treatment for a high probability of disease recurrence after allo-HSCT. Toxicities from IL-2 were transient fever, fatigue and local inflammation. In one patient GvHD grade III with no clear association to IL-2 administration occurred. IL-2 administration was started at median day 57 (range 13-154) post-transplant for a mean duration of 28 days (range 15-250). IL-2 administration clearly increased NK cell activity. 3 of 11 patients (ALL, AML, multifocal Ewings sarcoma) survived with a follow-up of ten years. In conclusion, long-term low-dose IL-2 subcutaneous application is feasible in children due to a low side effect profile even after HLA mismatched transplantation and may be a strategy to prevent relapse in pediatric malignancies with extremely high risk of relapse.
Item Description:Gesehen am 12.10.2022
Physical Description:Online Resource
ISSN:1532-1924
DOI:10.1016/j.beha.2011.04.007

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