Immunotherapy of advanced refractory multiple myeloma with idiotype-pulsed dendritic cells (mylovenge)

M. MacKenzie, M. V. Peshwa, Theodore Wun, J. Wolf, J. Mason, V. Caggiano, C. Redfern, G. Strang, F. Valone

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10 Scopus citations

Abstract

Mylovenge (APC8020) is an immunotherapy product consisting of autologous dendritic cells pulsed with the patient's immunoglobulin idiotype, which is a tumorspecific antigen. We are performing a trial of Mylovenge for treatment of patients with myeloma that is progressive after standard therapy. We have treated 42 patients and data are available for all 42. There are three patient groups: Patients with progressive disease after standard dose chemotherapy with high tumor burden (group 1, 16 patients) or intermediate tumor burden (group 2, 12 patients) and patients with disease progression after autologous stem cell transplantation (group 3, 14 patients). The median number of prior chemotherapy regimens was 3 (range 1 - 6). 45% had received radiation therapy and 52% had elevated B2 microglobulin. The table provides other demographic information. Group Age M/F IgG/IgA M Protein ECOG 0/1 B2M 1 69 9/7 13β 3.3 9/7 3.2 2 69 8/4 8/4 2.1 6/6 2.0 3 59 9/5 10/4 3.5 8/6 3.7 Mylovenge was prepared and infused in weeks 0, 4, 8, and 24 (patients 1 - 31) or weeks 0, 2. 4, and 24 (patients 32 - 42). Treatment was well tolerated. There were five treatment-related adverse events ( 11.9% of patients; 3% of infusions): 2 headaches, 1 sore arm, and 2 dyspnea. Sixteen patients (38%) appeared to benefit from treatment. Fifteen of these were in groups 1 and 2 (15/28, 54%). Six patients had minor decreases in serum M protein and 10 had disease stabilization 35 weeks with 4 having stabilization 18 months. The median time to progression was: group 1: 37.8 weeks; group 2: 32.0 weeks; and group 3: 12.4 weeks. Treatment with Mylovenge is well tolerated and benefits 1β to 1/2 of heavily pre-treated patients who are resistant to standard therapy. We have extended this trial to include patients with stable, low tumor burden after autologous stem cell transplantation.

Original languageEnglish (US)
JournalBlood
Volume96
Issue number11 PART I
StatePublished - 2000

ASJC Scopus subject areas

  • Hematology

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