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Resume Introduction. – L’immunotherapie adoptive, depuis son introduction dans les annees 1980, a fait l’objet de nombreuses etudes tant chez l’animal que chez l’homme et constitue une approche therapeutique innovante et prometteuse. Actualites et points forts. – Si les premiers essais realises en therapie anticancereuse, au moyen de lymphocytes actives (LAK) ou de lymphocytes T isoles a partir de tumeur (TIL) ont ete limites par les effets secondaires dus a l’Il-2, l’utilisation des cellules derivees des monocytes a des fins therapeutiques a ete tres bien toleree, ce qui a permis d’optimiser les protocoles d’immunotherapie adoptive en utilisant des procedures standardisees. Des essais cliniques de phase II associant les macrophages actives a des anticorps dans le traitement de tumeurs solides sont en cours. Perspectives et projets. – De nombreux travaux permettent d’entrevoir les potentialites offertes par les cellules presentant des antigenes (macrophages et cellules dendritiques) en matiere d’immunotherapie adoptive. Les premiers resultats cliniques obtenus avec les cellules dendritiques dans le cancer de la prostate et dans le melanome, sont particulierement prometteurs.

Ninety-three collections of leucocytes by cytapheresis followed by separation of monocytes by centrifugal elutriation were undertaken in twelve metastatic cancer patients (four melanomas, six colon carcinomas, one ovarian carcinoma, and one lung cancer). The leucaphereses were performed aiming to collect a product, ready for introduction into the elutriation chamber, i.e., with low contamination by erythrocytes and granulocytes. The median collection of leucocytes was 7.3 x 10(9). After elutriation, purified monocytes (mean: 0.91 x 10(9)) were cultured with 3-5% autologous serum for 7 days in the presence of 250 IU/ml of recombinant human gamma-interferon (Rh-IFN gamma) for the last 18 h of culture. The median number of activated macrophages (MAK) available for reinfusion was 2.4 x 10(8) for each culture. The phenotypes and the antitumoral potentiality of MAK cells were documented. Reinfusions performed i.v. or i.p. were well tolerated with no major side effects. No complete tumor response was obtained. One partial response and two stabilizations of the disease were observed in one melanoma and two colon carcinomas.