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Combined Transplant/Vaccine Therapy Shows Promise for High-Risk Leukaemia BOSTON -- August 24, 2009 -- Two of the most powerful approaches to cancer treatment, a stem cell transplant and an immune system-stimulating vaccine, appear to reinforce each other in patients with high-risk acute myeloid leukaemia (AML) or advanced myelodysplasia, according to a study published in the online early edition of the Proceedings of the National Academy of Sciences. The researchers reported that patients with high-risk AML or advanced myelodysplasia who received a cancer vaccine shortly after a stem cell transplant not only had few complications but also mounted a strong immune system attack on the disease. Particularly encouraging was the fact that rates of graft-versus-host disease (GVHD) were no higher than with stem cell transplants alone. The key to the technique’s success was the timing of the vaccine, explained the study’s co-senior author, Glenn Dranoff, MD, Dana-Farber Cancer Institute, Boston, Massachusetts. “In previous studies that have combined stem cell transplantation with a cancer vaccine, the vaccine wasn’t given until a significant amount of time after the transplant.” The study involved 28 patients with advanced myelodysplasia or high-risk AML. Twenty-four underwent a transplant of hematopoietic stem cells after receiving chemotherapy from a matched donor. Between 30 and 45 days after transplant, 15 of the patients began receiving a cancer vaccine. The vaccine was made by surgically removing cancerous or myelodysplasic tissue from patients and genetically altering the diseased cells so they would produce GM-CSF. Ten of the participating patients completed the full course of 6 vaccinations (the others had to drop out of the trial because of rapidly advancing disease). Of the 10 who received the entire vaccine course, 9 are alive and in full remission up to 4 years after treatment. Although the only way to determine whether the combined transplant/vaccine approach is superior to transplant alone is to compare them head-to-head in a clinical trial, the results of the current study are highly encouraging, said co-senior author Robert Soiffer, MD, of Dana-Farber. Historically, only about 20% of similar high-risk AML and myelodysplasia patients who receive a transplant survive for at least 2 years. SOURCE: Dana-Farber Cancer Institute E-mail this page to a friend or colleague! To print, use this version