Dendritic cell-tumor cell hybrid vaccination for metastatic cancer.

Dendritic cells are the most potent antigen-presenting cells, and the possibility of their use for cancer vaccination has renewed the interest in this therapeutic modality. Nevertheless, the ideal immunization protocol with these cells has not been described yet. In this paper we describe the preliminary results of a protocol using autologous tumor and allogeneic dendritic hybrid cell vaccination every 6 weeks, for metastatic melanoma and renal cell carcinoma (RCC) patients. Thirty-five patients were enrolled between March 2001 and March 2003. Though all patients included presented with large tumor burdens and progressive diseases, 71% of them experienced stability after vaccination, with durations up to 19 months. Among RCC patients 3/22 (14%) presented objective responses. The median time to progression was 4 months for melanoma and 5.7 months for RCC patients; no significant untoward effects were noted. Furthermore, immune function, as evaluated by cutaneous delayed-type hypersensitivity reactions to recall antigens and by peripheral blood proliferative responses to tumor-specific and nonspecific stimuli, presented a clear tendency to recover in vaccinated patients. These data indicate that dendritic cell-tumor cell hybrid vaccination affects the natural history of advanced cancer and provide support for its study in less advanced patients, who should, more likely, benefit even more from this approach.

Antileucotrienos em asmáticos corticodependentes – relato de seis casos / Antileukotriene in steroid dependent asthma – report of six cases

Objetivo: Descrever a experiência com o uso de antileucotrienos em seis pacientes com asma grave corticodependente, acompanhados no Serviço de Alergia e Imunopatologia do Hospital do Servidor Público Estadual de São Paulo. Pacientes e métodos: Por um período de três meses os pacientes maiores de doze anos receberam aleatoriamente zafirlucaste 20mg de 12/12h ou montelucaste 10mg/dia e os menores de 12 anos montelucaste 5mg/dia. Os parâmetros avaliados foram: necessidade do uso diário de corticosteróides sistêmicos (oral), escore clínico de sintomas, prova de função pulmonar realizada antes da introdução da medicação e após três meses de acompanhamento. Resultados: Houve melhora do escore clínico em todos os pacientes (exceto um), melhora da prova de função pulmonar em apenas três dos pacientes, porém todos reduziram de forma significativa o uso diário de corticosteróides sistêmicos. Conclusão: Concluímos que na população avaliada, os pacientes em muito se beneficiaram com o uso de antileucotrienos, sugerindo que esta medicação tenha um papel no tratamento da asma grave corticodependente, para tanto, novos estudos serão necessários.