Immunological responses in a patient with glioblastoma multiforme treated with sequential courses of temozolomide and immunotherapy: case study

Cytotoxic chemotherapy that induces lymphopenia is predicted to ablate the benefits of active antitumor immunization. Temozolomide is an effective chemotherapeutic agent for patients with glioblastoma multiforme, but it induces significant lymphopenia. Although there is monthly fluctuation of the wh...

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Bibliographic Details
Published inNeuro-oncology (Charlottesville, Va.) Vol. 10; no. 1; pp. 98 - 103
Main Authors Heimberger, Amy B, Sun, Wei, Hussain, S Farzana, Dey, Mahua, Crutcher, Lamonne, Aldape, Ken, Gilbert, Mark, Hassenbusch, Samuel J, Sawaya, Raymond, Schmittling, Bob, Archer, Gary E, Mitchell, Duane A, Bigner, Darell D, Sampson, John H
Format Journal Article
LanguageEnglish
Published England Duke University Press 01.02.2008
Subjects
Antineoplastic Agents, Alkylating
Brain Neoplasms - immunology
Brain Neoplasms - therapy
Cancer Vaccines - immunology
Cancer Vaccines - therapeutic use
Case Studies/Case Illustration
Combined Modality Therapy
Dacarbazine - analogs & derivatives
Flow Cytometry
Glioblastoma - immunology
Glioblastoma - therapy
Humans
Immunotherapy - methods
Male
Middle Aged
Radiotherapy
Receptor, Epidermal Growth Factor - immunology
Receptor, Epidermal Growth Factor - metabolism
T-Lymphocyte Subsets - immunology
T-Lymphocytes - immunology
Vaccines, Subunit
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Summary:Cytotoxic chemotherapy that induces lymphopenia is predicted to ablate the benefits of active antitumor immunization. Temozolomide is an effective chemotherapeutic agent for patients with glioblastoma multiforme, but it induces significant lymphopenia. Although there is monthly fluctuation of the white blood cell count, specifically the CD4 and CD8 counts, there was no cumulative decline in the patient described in this case report. Depriving patients of this agent, in order to treat with immunotherapy, is controversial. Despite conventional dogma, we demonstrated that chemotherapy and immunotherapy can be delivered concurrently without negating the effects of immunotherapy. In fact, the temozolomide-induced lymphopenia may prove to be synergistic with a peptide vaccine secondary to inhibition of regulatory T cells or their delayed recovery.
ISSN:1522-8517
1523-5866
DOI:10.1215/15228517-2007-046