79 research outputs found
Dendritic cell vaccination as postremission treatment to prevent or delay relapse in acute myeloid leukemia
Relapse is a major problem in acute myeloid leukemia (AML) and adversely impacts survival.
In this phase II study, we investigated the effect of vaccination with dendritic cells (DCs)
electroporated with Wilms’ tumor 1 (WT1) mRNA as post-remission treatment in 30 AML
patients at very high risk of relapse. There was a demonstrable anti-leukemic response in 13
patients. Nine patients achieved molecular remission as demonstrated by normalization
of WT1 transcript levels, 5 of which are sustained after a median follow-up of 109.4 months.
Disease stabilization was achieved in 4 other patients. Five-year overall survival (OS) was
higher in responders than in non-responders (53.8% vs. 25.0%; P=0.01). In patients
receiving DCs in first complete remission (CR1), there was a vaccine-induced relapse
reduction rate of 25% and the 5-year relapse-free survival was higher in responders than in
non-responders (50% vs. 7.7%; P65 years who received DCs
in CR1, 5-year OS was 69.2% and 30.8% respectively, as compared to 51.7% and 18% in
the Swedish Acute Leukemia Registry (SALR). Long-term clinical response was correlated
with increased circulating frequencies of poly-epitope WT1-specific CD8+ T-cells. Long-term
OS was correlated with interferon-γ+ and tumor necrosis factor-α+ WT1-specific responses in delayed type hypersensitivity-infiltrating CD8+ T-lymphocytes. In conclusion, vaccination of
AML patients with WT1 mRNA-electroporated DCs can be an effective strategy to prevent or
delay relapse after standard chemotherapy, translating into improved OS rates, which are
correlated with the induction of WT1-specific CD8+ T-cell response. This trial was registered
at www.clinicaltrials.gov as #NCT00965224
Improving diagnosis of von Willebrand disease: Reference ranges for von Willebrand factor multimer distribution
Clinical and microbiological impact of long-term discontinuation of fluoroquinolone prophylaxis in haematological patients with prolonged profound neutropenia
Successful pregnancy in a patient with factor V deficiency : case report and review of the literature
The quality of oral anticoagulant therapy and recurrent venous thrombotic events in the Leiden Thrombophilia Study
Essential Differences in Clinical and Bone Marrow Features in BCR/ABL-Positive Thrombocythemia Compared to Thrombocythemia in the BCR/ABL-Negative Myeloproliferative Neoplasms Essential Thrombocythemia and Polycythemia Vera
Pseudohemophilia of Erik von Willebrand caused by homozygous one nucleotide deletion in exon 18 of the VW-factor gene
Laboratory diagnosis of von Willebrand disease type 1/2E (2A subtype IIE), type 1 Vicenza and mild type 1 caused by mutations in the D3, D4, B1-B3 and C1-C2 domains of the von Willebrand factor gene: role of von Willebrand factor multimers and the von Willebrand factor propeptide/antigen ratio
Coagulation factor activity and clinical bleeding severity in rare bleeding disorders : results from the European Network of Rare Bleeding Disorders
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