[Adoptive immunotherapy in patients with medulloblastoma by LAK cells]

Medulloblastoma is one of the most popular malignant brain tumors in children. It accounts for about 15% of all pediatric brain tumors. Radiochemotherapy has prolonged the 5-year survival rate up to 60-85% for patients with medulloblastoma. But the conventional therapy is not so effective to recurrent cases, especially with meningeal dissemination, and generally fatal. There remains a big problem of the neurotoxicity to infants in a growth process under the whole-neuraxis irradiation and chemotherapy. Aiming to relieve the radiation and antitumor drugs, adoptive immunotherapy is greatly expectant. We have had clinical trials of adoptive immunotherapy for 8 patients with medulloblastoma by lymphokine-activated killer (LAK) cells. They were from 2-9 years in age and had cerebrospinal fluid (CSF) dissemination of the tumors. All patients underwent the whole-neuraxis irradiation and chemotherapy. After they had CSF dissemination, they were submitted to an adoptive transfer of allogeneic LAK cells. LAK cells were induced from peripheral blood lymphocytes (PBL) of their relatives with human recombinant interleukin-2. 3-15 x 10(9) LAK cells were transferred intrathecally in 2-3 months. In 3 of 8 patients, neurological signs were improved and malignant cells had never been detected on CSF cytology after the adoptive immunotherapy. One among these 3 patients showed complete response in 20 months. Thus, this is an attractive treatment for patients with medulloblastoma, especially with CSF dissemination, which cannot be cured by current therapeutic intervention.