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Vaccine response seen in patients with stable chronic myeloid leukemia

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A new vaccine (CMLVAX100) reduces residual disease in some patients with chronic myeloid leukemia (CML) already treated with imatinib or interferon alfa, results of a phase II study suggest. In some cases it even leads to complete cytogenetic remission.

Current treatments with imatinib or interferon alfa often control CML, while failing to effect a total cure, Dr. Monica Bocchia of Siena University and colleagues explain in the February 19th issue of The Lancet. CMLVAX100 targets the 210 fusion protein derived from the aberrant BCR-ABL gene.Dr. Bocchia and her team administered six injections of CMLVAX100 over 3 months to 16 patients with stable CML who were known to carry the b3a2 fusion point of BCR-ABL p210 protein. The vaccine was co-administered with granulocyte-macrophage colony-stimulating factor (molgramostim) and QS-21 as adjuvants.All 10 treated with imatinib had improved cytogenetic responses, as did five of the six on interferon alfa. Complete cytogenetic remission was achieved in seven after 3 months. In three of the imatinib-treated patients and one interferon alfa-treated patient, the authors observed undetectable amounts of BCR-ABL transcripts according to polymerase chain reaction testing.”Overall, we recorded peptide-specific delayed-type hypersensitivity (in 11 of 16 patients), CD4 cell proliferation (13 of 14 assessed), and interferon gamma production (five of five assessed),” Dr. Bocchia’s team reports.These findings seem to favor the “vaccine as additional antileukemic treatment,” they conclude. More extended studies with a larger cohort are now underway.Although other research groups have performed similar studies, the one by Dr. Bocchia’s group is the first to show a clinical response, Dr. K. K. Wong Jr. and Dr. Saswati Chatterjee, both from the City of Hope National Medical Center in Duarte, California, comment in an accompanying editorial.The difference may lie in the fact that the patients chosen here were all known to have HLA alleles that bind the fusion peptides and had stable disease. Perhaps also pertinent is their use of molgramostim as an adjuvant.Nevertheless, “given the ease of administration, lack of toxicity, and early promise of efficacy, vaccine development against BCR-ABL or other CML-specific antigens appears to be a reasonable avenue for further investigation,” Dr. Wong and Dr. Chatterjee conclude.(Source: Lancet 2005;365:631-632,657-662: Oncolink: February 2005.)


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Posted On: 18 February, 2005
Modified On: 16 January, 2014

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