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Treatment of chemotherapy resistant malignant pleural effusion with injection of autologous immature dendritic cells
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Abstract:
Objective: To evaluate the effect and safety of intrapleural injection of in vitro expanded immature dendritic cells (DC) for the treatment of malignant pleural effusion. Methods: Peripheral blood mononuclear cells were collected from 6 patients with chemo-resistant malignant pleural effusion and cultured with cytokines to expand immature DC in vitro . The cells were then intrapleurally injected into the patients (5~10)×107 every 4 weeks for 3 times as a course of treatment. The changes of pleural effusion and side effects in each patient were examined. T cell and NK cell subsets in the pleural effusion were analyzed by flow cytometry. Results: Overall, 2 renal cell carcinoma patients had complete responses, 1 lung cancer patients had partial response, 1 lung cancer patients had SD, and 2 other patients had PD. Therefore, the response rate was 50% (3/6) and the benefit rate was 66.7%. Duration of the response of the 2 renal cell carcinoma patients was 26 weeks and 147 weeks respectively. After DC treatment, the percentages of T and NK cells increased in the pleural effusion, but only the increase of NK cells is statistically significant. Conclusion: This pilot study indicated that intrapleural injection of none-antigen loaded immature DCs is well-tolerated, has positive effect on the management of malignant pleural effusions, which is likely mediated by NK cells. These results suggest that DC immunotherapy is a promising method to treat malignant pleural effusions in the future.
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Project Supported:
Project supported by the “Six Top Talents Foundation” of Jiangsu Province（No.2010-WS-012）
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