Cell Based Autologous Immune Enhancement Therapy (AIET) after Radiotherapy in a Locally Advanced Carcinoma of the Cervix

Abstract

Radiotherapy is the primary form of treatment in patients with locally advanced cervical carcinoma. However for residual disease in the form of the persistent lymph nodes, surgery or chemotherapy is recommended. As surgery is not acceptable by every patient and chemotherapy has associated side effects, we hereby report the positive outcome of in vitro expanded natural killer cell and activated T lymphocyte based autologous immune enhancement therapy (AIET) for the residual lymphadenopathy in a patient with locally advanced cervical cancer after radiation. After six transfusions of AIET, there was complete resolution of residual lymph nodes and there was no evidence of local lesion. The patient also reported improvement in quality of life. As AIET has been reported as the least toxic among the available therapies for cancer, combining AIET with conventional forms of therapy in similar patients might not only improve the outcome but may also help the patients achieve a good quality of life.

Phase I Clinical Trial Using Autologous Ex Vivo Expanded NK Cells and Cytotoxic T Lymphocytes for Cancer Treatment in Vietnam

“…This could be explained by the fact that the immune cell infusion has a significant positive effect on the change in social and family life aspects of our patients. Our results are consistent with those of authors who reported a significant improvement in the quality of life of these different scales during follow-up [24,28,29,30,31,32,35]. As for the symptom scales of EORTC QLQ-C30, they revealed a significant decrease in the severity of symptoms for fatigue, vomiting, pain, dyspnea, constipation, and diarrhea scales.…”

“…In another case of a locally advanced carcinoma of the cervix, the average numbers of expanded NK cells and CTLs were 282.5 × 10 6 and 478.5 × 10 6 , respectively. After six transfusions, a complete resolution of retroperitoneal lymph node was achieved with no evidence of the local lesion of the cervix [30]. A case report of a stage IV colonic cancer patient described an average fold expansion of NK cells and CTLs at 44- and 168-fold, respectively [31].…”

“…Previous studies using autologous NK cells and CTLs for cancer treatment utilized highly variable doses of cells for infusion [22,23,24,25,27,28,29,30,31,32]. To date, there is no generally accepted or suggested limitation for the dose of immune cell transfusion [27,28].…”

“…The combination of two kinds of immune cells, including NK cells and CTLs, promises to be advantageous in the detection and killing of cancer cells with or without MHC-I expression. Many clinical studies have demonstrated the efficacy of the combination between these two kinds of immune cells in pre-clinical research models and clinical trials [5,23,25,26,27,28,29,30,31,32]. Expansion of immune cells by using BINKIT, developed by Dr. Terunuma Hiroshi (Biotherapy Institute of Japan, Tokyo, Japan), were proven to efficiently induce the number of selective cells and activate them to kill cancer cells [25,26,27,28,29,30,31,32].…”

Cell-based immunotherapy in stage IIIA inflammatory breast cancer with declining innate immunity following successive chemotherapies: A case report

“…A quantity of 185 ml of PB was withdrawn for the 11 and 12th transfusions. For each AIET transfusion, the NK cells isolated from peripheral blood mononuclear cells were culture-expanded in vitro, employing autologous plasma without using feeder layers or animal or allogeneic serum, based on previously described protocols (11,(15)(16)(17) for 10-12 days before being infused into the patient. The patient also underwent 5,400 cGy in 27 fractions of radiotherapy between March 2013 and April 2013.…”