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- W2247687564 abstract "6534 Background: Autologous (auto) SCT can lead to CR and prolonged survival in myeloma patients (pts) but cure is rare. Post-SCT infusion of auto T-cells may improve outcome and accelerate lymphocyte recovery, reduce immune suppression, and allow for improved immune response. Ex-vivo stimulation of auto T-cells using anti-CD3/CD28 laden magnetic beads may augment an auto graft-vs-myeloma effect. We treated 54 pts with high-dose melphalan and SCT followed by co-stimulated T-cell infusion and pneumococcal conjugate vaccine (PCV, Prevnar) randomly assigned to 4 different groups Methods: After lymphocyte pheresis, pts underwent cytoxan (4g/m2) + GCSF and stem cell collection, then melphalan 140–200mg/m2 followed by stem cell infusion. T-cells were cultured for ∼12 days with anti-CD3/anti-CD28-immunomagnetic beads + IL-2 (100 units/ml). 12 patients received stimulated T-cells day(d) +12 alone. The other 42 pts participated in a 2 x 2 randomization of early vs late T-cell infusion (d+12 vs d+100) and early vs late PCV immunization (both groups receiving two doses d+30 and d+90 but the early group receiving a third dose prior to the stem cell infusion) Results: Median age was 56 (38–71), 67% male, 19% non-caucasion, 22% IgA, 20% Bence Jones, 15% abnormal karyotype, median β2M 3.3. Maximal response was 12 CR, 21 nCR, 20 PR 1 unevaluable (98% RR, 61% CR+nCR). 1.5 year survival was 78%. T-cell infusion events were most commonly chills. fever,and nausea generally less than grade 2. 12% developed facial or upper body rash. 52 pts received a mean 8 x 109 CD3+ cells. Day + 42 CD4 and CD8 counts were greater in the early vs late T-cell infusion group (p<0.04). Pneumococcal antibody response to PCV was greatest in the group immunized pre-transplant and receiving early T-cells and cellular PCV response was augmented in those receiving early T-cell infusion. Conclusions: Infusion of co-stimulated auto T-cells early after SCT for myeloma accelerates T-cell recovery and augments antibody and cellular immune response to PCV vaccine with low additional toxicity. This approach holds promise for other anti-microbial and tumor vaccines. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration excite" @default.
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- W2247687564 date "2005-06-01" @default.
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- W2247687564 title "Co-stimulated autologous T-cell infusion after autologous stem cell transplantation (SCT) for myeloma accelerates lymphocyte recovery and augments response to pneumoccal vaccine: Results of a randomized trial" @default.
- W2247687564 doi "https://doi.org/10.1200/jco.2005.23.16_suppl.6534" @default.
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