Transient expansion of peptide-specific lymphocytes producing IFN-gamma after vaccination with dendritic cells pulsed with MAGE peptides in patients with mage-A1/A3-positive tumors.

Assessment of T-cell activation is pivotal for evaluation of cancer immunotherapy. We initiated a clinical trial in patients with MAGE-A1 and/or -A3 tumors using autologous DC pulsed with MAGE peptides aimed at analyzing T-cell-derived, IFN-gamma secretion by cytokine flow cytometry and ELISPOT. We also tested whether further KLH addition could influence this response favorably. Monocyte-derived DC were generated from leukapheresis products. They were pulsed with the relevant MAGE peptide(s) alone in group A (n=10 pts) and additionally with KLH in group B (n=16 pts). A specific but transient increase in the number of peripheral blood T lymphocytes secreting IFN-gamma in response to the vaccine peptide(s) was observed in 6/8 patients of group A and in 6/16 patients of group B. We conclude that anti-tumor vaccination using DC pulsed with MAGE peptides induces a potent but transient anti-MAGE, IFN-gamma secretion that is not influenced by the additional delivery of a nonspecific, T-cell help.

[Treatment of Hodgkin's disease by chemotherapy with MOPP alone. Long-term results]. / Traitement de la maladie de Hodgkin par chimiothérapie MOPP seule. Résultats à long terme.

Between 1967 and 1978, 152 Algerian patients (31 children and 121 adults) with Hodgkin's disease were treated with the mechlorethamine, vincristine, procarbazine, prednisone combination (MOPP) alone and without radiotherapy. They were separated without lymphography into limited stage (n = 37) and extensive (n = 115) stage. The high initial failure rate (54%) was principally due to inadequate symptomatic treatment and to the patients' low socio-economic status. The complete remission rate was 45% (54% for limited stages; 42% for extensive stages) and significantly higher in women (58%) than in men (37%). In 20/23 cases relapses occurred during the first 4 years of complete remission; however, the final relapse was observed during the 12th year of complete remission. The actuarial relapse rate at 15 years was 48%. The long-term (10-15 years) life expectancy was 31% overall and 70% in cases with complete remission. Prognosis was significantly better in patients with limited forms and/or without systemic symptoms.

Homing mechanisms in the etiopathogenesis of multiple myeloma.

Although multiple myeloma (MM) is characterized by a monoclonal expansion of plasma cells, it has been assumed that the tumor clone also includes more immature B cells. We could demonstrate by DNA sequence analysis of the variable region in immunoglobulin (Ig) heavy chain genes, that myeloma patients have peripheral blood monoclonal B cells that have not switched their Ig isotype but are somatically hypermutated. This finding suggests that myeloma originates from a germinal center B cell of the lymph node, most probably a memory B cell or B lymphoblast. The identification of these cells in the peripheral blood circulation implies that they must be equipped with homing receptors that allow them to migrate from the lymph node to the marrow environment. Within the marrow compartment these precursors will receive the appropriate differentiation signals to become mature tumor cells. The growth and survival of these bone marrow (BM) plasma cells is believed to be regulated by a functional interplay with the surrounding marrow stroma involving different adhesive mechanisms and the action of several cytokines. We found that myeloma plasma cells express several adhesion molecules (ICAM-1, N-CAM, CD44, VLA-4). Myeloma cell lines can bind to purified fibronectin (FN) using mostly the VLA-4 receptor. However this interaction contributes only partially to binding with intact stromal layers. In contrast, the post-HDM aplasia was significantly shortened in two of the schedule B patients (3 to 10 days) and was followed by a 25- to 165-fold increase in CD34+ cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adhesive interactions between tumour cells and bone marrow stromal elements in human multiple myeloma.

Long-term bone marrow cultures (LTBMC) were established from marrow samples obtained from 6 myeloma patients and 5 healthy donors and were examined by in situ immunogold-silver staining. During the culture period, the established stroma in myeloma LTBMC revealed a lower level of confluency compared to the normal LTBMC. In addition, an increasing proportion of macrophages and osteoclasts was observed in the myeloma stroma throughout the culture period. Moreover, plasma cells were detectable by wk 8, mostly organized in small clusters. They strongly expressed VLA-4 (6/6), H-CAM (6/6), ICAM-1 (6/6) and N-CAM (3/6). In most cases, a weak expression of the other members of beta 1-integrins was observed. The expression of beta 2-integrins was always absent. Stromal fibroblasts were found to be weakly positive for VLA-2, VLA-3 and VLA-5 and showed strong expression of VCAM-1, H-CAM and ICAM-1. N-CAM expression could not be detected. By comparing the adhesion molecule profile of the stromal cells in myeloma cultures with normal bone marrow (BM) cultures, no particular defects could be observed. The stroma displayed most of the potential ligands which could interact with adhesion molecules detected on the myeloma cells. Among these ligands we could find fibronectin and VCAM-1 for VLA-4, collagen I for VLA-2 and VLA-3 and laminin for VLA-2, 3 and 6. Four myeloma cell lines, i.e. OPM-1, U266, RPMI 8226 and JJN3, with a representative phenotype, were used to study the adhesive interactions of myeloma cells with the BM microenvironment. All the myeloma cell lines bound strongly to the marrow cell layers and also showed a high binding to purified fibronectin (FN). However, the adhesion of the cell lines to intact stroma could not be significantly inhibited by anti-FN receptors antibodies. Nor could it be prevented when the latter were combined with anti-H-CAM, V-CAM and ICAM-1 antibodies, as tested in the JJN3 cell line. This implies that other unknown mechanisms contribute to the myeloma cell binding.