Plasma exchange in six patients with advanced cancers of the head and neck

Seder, Richard H.; Katz, Arnold E.; Keggins, John J.; Blanchard, G. C.; Oh, Se‐Kyung; Berman, Leonard D.; Vaughan, Charles W.; Hong, Waun Ki; Strong, M. Stuart

doi:10.1002/jca.2920020307

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Plasma exchange has been used in patients with far advanced head and neck cancer and has been reasonably well tolerated [27]. Patients with advanced SCCHN who had elevated circulating immune complex and no currently available therapy were deemed appropriate candidates for an experimental clinical protocol.…”

Section: Discussionmentioning

confidence: 99%

“…Previous radiotherapy precluded its further use, and surgery was unlikely to result in even reasonable palliation. Therefore, the patient was entered into an experimental protocol that involved repeated plasma exchange, as a potential means of inducing tumor regression [27]. Procedures were performed on a continuous-flow cell separator (SPECTRA) using acid citrate/dextrose A in a 1 : 10 ratio with whole blood.…”

Section: Clq Binding Testmentioning

confidence: 99%

See 1 more Smart Citation

Inhibition of lymphokine-activated killer cell generation by blocking factors in sera of patients with head and neck cancer

Bugis

Lotzová

Savage

et al. 1990

Cancer Immunol Immunother

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Cytolytic activation of peripheral blood lymphocytes by recombinant interleukin-2 (rIL-2) in patients with squamous cell carcinoma (SCC) of the head and neck may be inhibited by serum blocking factors, and this could influence therapeutic efficacy. Peripheral blood lymphocytes from 21 patients with this disease and 17 controls were incubated with 10-1000 U rIL-2 for 6 days in supplemented complete medium (containing 10% fetal calf serum) or the same medium plus 10% autologous serum. After washing the effector cells, we determined their cytotoxicity against K562 and MDA1386, a lymphokine-activated-killer(LAK)-sensitive SCC cell line, using a 51Cr-release assay. Patient sera inhibited LAK-generated lysis of both MDA1386 and K562, while control sera from healthy persons inhibited LAK-generated lysis of MDA1386. The blocking activity of patient sera tended to be greater than that of control sera. The sera of patients with untreated or recurrent disease and those who were free of disease had equivalent inhibitory capacity. The serum blocking factor acted in a dose-dependent manner, and inhibition was overcome by increasing the dose of rIL-2. Levels of circulating immune complexes (measured by the C1q binding method) did not correlate significantly with inhibition. A clinical protocol of repeated plasma exchange in patients with advanced and recurrent squamous cell carcinoma of the head and neck allowed sequential study of one patients's serum before, during, and after treatments. Plasmapheresis removed serum inhibitory factors, albeit temporarily. The activity of serum blocking factors in patients with this disease can be modulated by increasing doses of rIL-2 and by plasma exchange. This modulation may be important to improving clinical response rates for patients undergoing immunotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Clq Binding Testmentioning

confidence: 99%

Inhibition of lymphokine-activated killer cell generation by blocking factors in sera of patients with head and neck cancer

Bugis

Lotzová

Savage

et al. 1990

Cancer Immunol Immunother

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“…Only a few patients with solid tumors have been treated with PP (19)(20)(21). These patients had advanced cancers of different types (breast, colon, melanoma, lung, thyroid).…”

Section: Plasmapheresis Therapymentioning

confidence: 99%

Therapeutic Apheresis in Malignancy

Nand

1997

Therapeutic Apheresis

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Plasmapheresis (PP), staphylococcal protein A immunoadsorption (SPI), and extracorporeal photochemotherapy (EP) have been utilized in cancer treatment for about 20 years. PP removes immune complexes and induces a temporary increase in T4/T8 ratio, natural killer cell activity, and blastogenic responses. SPI removes immune complexes, enhances lymphocytic responses, and activates complement. EP increases lysis of circulating lymphoma cells by CD8+ cytotoxic T cells and increases tumor necrosis factor production by host monocytes. PP induces partial remission in about 28% of patients, but this remission is short lived. SPI gives similar results. Addition of PP to chemotherapy has been reported to prolong survival in patients with multiple myeloma. EP appears useful in treating cutaneous T cell lymphomas with 25% of patients achieving complete response and 50% of patients attaining partial remission. Thus, PP and SPI induce short-lived immune responses, but have no proven clinical utility. EP may be useful in the treatment of cutaneous T cell lymphomas.

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“…Even though plasmapheresis has been used extensively in various malignancies, there are only a few reports (Table 11) of its use in a consistent manner or in the same histology [16,17,47,48]. Its most proven value is in the management of hyperviscosity syndromes associated with multiple myeloma and Waldenstrom's macroglobulinemia [49-5 11.…”

Section: Plasmapheresis and Protein A Immunoadsorption As Therapeuticmentioning

confidence: 99%

Therapeutic plasmapheresis and protein A immunoadsorption in Malignancy: A brief review

Nand

Molokie

1990

J of Clinical Apheresis

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Plasmapheresis is being used with considerable frequency in the management of malignant and non-malignant disorders. More recently, staphylococcal Protein A immunoadsorption has been employed in similar clinical situations. In patients with malignancy, plasmapheresis has been shown to produce alterations in plasma proteins, decrease circulating immune complexes, remove "specific" and "non-specific" blocking factors, change immune reactivity, and affect monocyte function. Partial responses have been reported in a small number of patients with carcinoma of lung, colon, and breast following plasmapheresis. In addition, there are reports of favorable responses in patients with melanoma, head and neck tumors, lymphomas, leukemias, and Kaposi's sarcoma in acquired immune deficiency. All these responses were partial and brief, and the treatment did not alter the course of the disease. Plasmapheresis has been useful in the management of hyperviscosity and occasionally of paraneoplastic syndromes. It may also have a role in the treatment of thrombotic thrombocytopenic purpura associated with mitomycin-C therapy. Protein A immunoadsorption, by which circulating immune complexes are selectively removed, can activate the complement system, increase blastogenic responses, and increase the natural killer cell activity. It has been shown to produce partial responses in breast and colon cancer, as well as Kaposi's sarcoma in acquired immune deficiency. It may have a useful role to play in the management of mitomycin-C-associated thrombotic thrombocytopenic purpura. Both plasmapheresis and Protein A immunoadsorption should be considered investigational interventions at this time. Toxicity of plasmapheresis, though uncommon, can be serious and may rarely be fatal. Toxicity of Protein A immunoadsorption is mild, consisting mainly of influenza-like symptoms and rash.

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Plasma exchange in six patients with advanced cancers of the head and neck

Cited by 8 publications

References 26 publications

Inhibition of lymphokine-activated killer cell generation by blocking factors in sera of patients with head and neck cancer

Inhibition of lymphokine-activated killer cell generation by blocking factors in sera of patients with head and neck cancer

Therapeutic Apheresis in Malignancy

Therapeutic plasmapheresis and protein A immunoadsorption in Malignancy: A brief review

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