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Clinical and immunologic responses to very low-dose vaccination with WT1 peptide (5 microg/body) in a patient with chronic myelomonocytic leukemia.
- Source :
-
International journal of hematology [Int J Hematol] 2007 Jun; Vol. 85 (5), pp. 426-9. - Publication Year :
- 2007
-
Abstract
- The wild-type Wilms tumor gene, WT1, is overexpressed in myelodysplastic syndrome (MDS) as well as acute myeloid leukemia. In a phase I clinical trial of biweekly vaccination with HLA-A*2402-restricted WT1 peptide for these malignancies, 2 patients with MDS developed severe leukocytopenia in association with a reduction in leukemic blast cells and levels of WT1 messenger RNA (mRNA) after only a single vaccination with 0.3 mg of WT1 peptide. These results indicated that the WT1-specific cytotoxic T-lymphocytes (CTLs) elicited by WT1 vaccination eradicated the WT1-expressing transformed stem or progenitor cells and that MDS patients with little normal hematopoiesis required a new strategy of WT1 vaccination to avoid severe leukocytopenia. We describe the first trial for a 57-year-old male patient with chronic myelomonocytic leukemia who was vaccinated biweekly with a small quantity (5 microg/body) of WT1 peptide. After the start of vaccination, the leukocyte and monocyte counts (13,780/microL and 1930/microL, respectively) gradually decreased to within the normal range in association with a reduction in the WT1 mRNA level. Simultaneously, the percentage of WT1-specific CTLs as measured by the HLA-WT1 tetramer assay increased. This case demonstrates for the first time that vaccination with as little as 5 microg of WT1 peptide can induce WT1-specific immune responses and resultant clinical responses.
- Subjects :
- CD8-Positive T-Lymphocytes cytology
Cell Differentiation
Dose-Response Relationship, Immunologic
Humans
Leukemia, Myelomonocytic, Chronic immunology
Leukocyte Count
Male
Middle Aged
Cancer Vaccines administration & dosage
Cancer Vaccines immunology
Leukemia, Myelomonocytic, Chronic drug therapy
WT1 Proteins administration & dosage
WT1 Proteins immunology
Subjects
Details
- Language :
- English
- ISSN :
- 0925-5710
- Volume :
- 85
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 17562620
- Full Text :
- https://doi.org/10.1532/IJH97.06194