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Immunotherapy using autologous monocyte‐derived dendritic cells pulsed with leukemic cell lysates for acute myeloid leukemia relapse after autologous peripheral blood stem cell transplantation

Although a second stem cell transplantation (SCT) can be used as salvage therapy in patients with relapsing leukemia after SCT, most of these patients have a poor outcome. We tried clinical vaccination using monocyte‐derived dendritic cells (DCs) pulsed with leukemic lysates to treat relapsing acute myeloid leukemia (AML) after autologous SCT. To generate DCs, CD14+ cells isolated from peripheral blood stem cell products were cultured in AIM‐V in the presence of GM‐CSF and IL‐4. Adding TNF‐α on day 6 induced maturation of the DCs, which were harvested on day 8 or 9. The DCs were incubated with tumor lysate and KLH for 2 hr at 37°C. After certifying the absence of microorganisms and endotoxins, the patients received four DC vaccinations at two‐ to three‐week intervals. Two patients received four DC vaccinations with means of 7.8 × 106 and 9 × 106 DCs at two‐ to three‐week intervals. The DC vaccinations were well tolerated with no apparent side effects. After the vaccinations, the patients showed immunological responses with positive delayed‐type hypersensitivity skin reaction and increasing autologous T cells stimulatory capacity to the DCs; however, the BM blast percentage of the patients did not improve. The results suggest that DCs are a feasible cellular therapy for relapsing AML after autologous SCT. J Clin Apheresis 19:66–70, 2004. © 2004 Wiley‐Liss, Inc.