Immune Reconstitution Following Autologous Stem Cell Transplantation in Patients with High-Risk Neuroblastoma at the Time of Immunotherapy.

Abstract

Outcomes for patients with high-risk neuroblastoma (HR-NBL) are significantly improved with the addition of immunotherapy (dinutuximab + cytokines) following autologous hematopoietic stem cell transplantation (auto-HSCT). We hypothesized that the immune system is not fully reconstituted at the initiation of immunotherapy. To test this hypothesis, we evaluated hematologic and immune subsets in 34 patients with HR-NBL before and after auto-HSCT. We found that absolute T, B, and NK cell counts at the time of immunotherapy were below normal in 80% of patients. Patients with residual disease at the time of transplantation had significantly lower absolute lymphocyte counts (ALC; P = .008), lower CD16+ cell counts (P = .009), and an abnormal ratio of cytokine-releasing to cytotoxic NK cells at the time of dinutuximab treatment. In addition, the preparative regimen used for auto-HSCT predicted immune recovery. Finally, higher total white blood cell count (P = .013) and ALC (P = .013) at 3 months after completion of therapy were measured in patients who remained in remission compared with those who relapsed. Our results indicate that most patients with HR-NBL do not have full immune reconstitution at the time of dinutuximab treatment after auto-HSCT, and that immune recovery may correlate with disease-related outcomes in patients with high-risk disease.

• Authors: Michele L Nassin, Elitsa Nicolaou, Sandeep Gurbuxani, Susan L Cohn, John M Cunningham, James L LaBelle
• Journal: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 24 Issue 3 Pg. 452-459 (03 2018) ISSN: 1523-6536 [Electronic] United States
• PMID: 29191664 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Antibodies, Monoclonal
• dinutuximab

Topics

• Adolescent
• Adult
• Antibodies, Monoclonal (administration & dosage)
• Autografts
• Child
• Child, Preschool
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Immunotherapy
• Infant
• Male
• Neuroblastoma (immunology, pathology, therapy)
• Recovery of Function (immunology)
• Retrospective Studies