Synopsis of clinical and immunologic characteristics of the 10 vaccinated patients
| No. . | Diagnosis . | Age, y . | WHO classification; karyotype . | Therapy before vaccination . | Status at vaccination . | Period of vaccination . | Level of IL-2 in ELISA . | CD8+ tetra+* . | ELISpot IFNγ . | ELISpot GrB . | Malignant cells, FACS . | Clinical findings . | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Before . | After . | Before . | After . | Before . | After . | ||||||||||
| 1 | AML | 66 | AML with maturation; normal karyotype, NPM1 mutation, FLT3-ITD negativ | VACI 05/2004, PR | PR | 12/04-01/05 | Up | Pos | 0 | 77 | 0 | 5 | 7 | 0.5 | Reduction of blasts in the BM*; relapse at +23 months |
| 2 | MDS | 72 | RAEB I; normal karyotype IPSS Int-1 | None | RAEB I | 02/05-03/05 | Up | Pos | 5 | 16 | 11 | 19 | 8 | 1 | Reduction of blasts in the BM*; normal WBC at +24 months |
| 3 | MM | 45 | IgA kappa; stage IIIA; no del13q14 ß2-MG 5.28 mg/L | DSMM V, autoTX 05+09/2002 | VGPR ß2MG: | 03/05-04/05 | Down | Pos | 5 | 24 | 0 | 9 | 3.5 | 0.5 | Reduction of plasma cells and kappa-LC (+23 months) |
| 4 | AML | 58 | AML with maturation; trisomy 8 | German intergroup arm, HiDAC, CR | Relapse | 04/05-06/05 | Stable | NC | 0 | 0 | 1 | 0 | 5 | 10 | PD |
| 5 | MDS | 80 | RCMD; not done IPSS Int-1 | Weekly erythrocyte and platelet transfusions | RCMD | 05/05-06/05 | Down | nt | 0 | 0 | 32 | 35 | 2 | 1 | NC |
| 6 | MDS | 81 | RA; 45,X,−Y IPSS low risk | Erythrocyte transfusions | RA | 05/05-06/05 | Up | Pos | 0 | 49 | nt | nt | 1.5 | 0.5 | Cessation of transfusions (+22 months) |
| 7 | MM | 67 | IgG kappa, stage IIIA del13q14 ß2-MG 4.5 mg/L | DSMM II, auto TX 07+09/2004 | PD ß2MG: | 06/05-07/05 | Stable | NC | 0 | 20 | 10 | 44 | nt | nt | PD |
| 8 | MM | 51 | IgG kappa stage IIIA; no del13q14 ß2-MG 1.27 mg/L | DSMM V, auto TX | VGPR | 06/05-07/05 | Stable | Pos | 0 | 5 | 29 | 56 | 1.5 | 1 | NC |
| 9 | AML | 44 | AML without maturation; complex karyotype; FLT3-ITD negative, NPM1 wild type | 2xICE, 1xHAM, auto TX | PR | 06/05-08/05 | Down | Pos | 3 | 0 | 0 | 14 | 6 | 7 | NC |
| 10 | MM | 70 | IgG kappa, stage IIIA; no del13q14 ß2-MG 4.4 mg/L | DSMM II, auto TX | VGPR ß2MG: | 07/05-08/05 | Up | Pos | 0 | 84 | 0 | 7 | 0.15 | 0.02 | Reduction of kappa-LC†; but PD at +4 months |
| No. . | Diagnosis . | Age, y . | WHO classification; karyotype . | Therapy before vaccination . | Status at vaccination . | Period of vaccination . | Level of IL-2 in ELISA . | CD8+ tetra+* . | ELISpot IFNγ . | ELISpot GrB . | Malignant cells, FACS . | Clinical findings . | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Before . | After . | Before . | After . | Before . | After . | ||||||||||
| 1 | AML | 66 | AML with maturation; normal karyotype, NPM1 mutation, FLT3-ITD negativ | VACI 05/2004, PR | PR | 12/04-01/05 | Up | Pos | 0 | 77 | 0 | 5 | 7 | 0.5 | Reduction of blasts in the BM*; relapse at +23 months |
| 2 | MDS | 72 | RAEB I; normal karyotype IPSS Int-1 | None | RAEB I | 02/05-03/05 | Up | Pos | 5 | 16 | 11 | 19 | 8 | 1 | Reduction of blasts in the BM*; normal WBC at +24 months |
| 3 | MM | 45 | IgA kappa; stage IIIA; no del13q14 ß2-MG 5.28 mg/L | DSMM V, autoTX 05+09/2002 | VGPR ß2MG: | 03/05-04/05 | Down | Pos | 5 | 24 | 0 | 9 | 3.5 | 0.5 | Reduction of plasma cells and kappa-LC (+23 months) |
| 4 | AML | 58 | AML with maturation; trisomy 8 | German intergroup arm, HiDAC, CR | Relapse | 04/05-06/05 | Stable | NC | 0 | 0 | 1 | 0 | 5 | 10 | PD |
| 5 | MDS | 80 | RCMD; not done IPSS Int-1 | Weekly erythrocyte and platelet transfusions | RCMD | 05/05-06/05 | Down | nt | 0 | 0 | 32 | 35 | 2 | 1 | NC |
| 6 | MDS | 81 | RA; 45,X,−Y IPSS low risk | Erythrocyte transfusions | RA | 05/05-06/05 | Up | Pos | 0 | 49 | nt | nt | 1.5 | 0.5 | Cessation of transfusions (+22 months) |
| 7 | MM | 67 | IgG kappa, stage IIIA del13q14 ß2-MG 4.5 mg/L | DSMM II, auto TX 07+09/2004 | PD ß2MG: | 06/05-07/05 | Stable | NC | 0 | 20 | 10 | 44 | nt | nt | PD |
| 8 | MM | 51 | IgG kappa stage IIIA; no del13q14 ß2-MG 1.27 mg/L | DSMM V, auto TX | VGPR | 06/05-07/05 | Stable | Pos | 0 | 5 | 29 | 56 | 1.5 | 1 | NC |
| 9 | AML | 44 | AML without maturation; complex karyotype; FLT3-ITD negative, NPM1 wild type | 2xICE, 1xHAM, auto TX | PR | 06/05-08/05 | Down | Pos | 3 | 0 | 0 | 14 | 6 | 7 | NC |
| 10 | MM | 70 | IgG kappa, stage IIIA; no del13q14 ß2-MG 4.4 mg/L | DSMM II, auto TX | VGPR ß2MG: | 07/05-08/05 | Up | Pos | 0 | 84 | 0 | 7 | 0.15 | 0.02 | Reduction of kappa-LC†; but PD at +4 months |
Age means age at the time of vaccination therapy. DSMM II/V (protocols II and V of the German Study Group for Multiple Myeloma): ID, IEV, Mel, double-auto/auto-allo-stem cell transplantation. The ELISpot numbers indicated in the table were calculated as follows: before, R3-specific spots minus background spots before vaccination; Max, maximum difference of R3-specific spots minus background spots during or after vaccination; w/o, without.
ID indicates idarubicin/dexamethasone; IEV, ifosfamid/epirubicin/etoposide; Mel, melphalan; LC, serum free light chains; Pos, increase; nt, not tested; response criteria according to Jäger et al36 ; Britten et al37 ; Jager et al38 , and Parmiani et al39 ; CR, complete remission; PR, partial remission; NC, no change; PD, progressive disease; RCMD, refractory cytopenia with multilineage dysplasia; HiDAC, high-dose arabinoside C; VACI, valproic acid, arabinosids C, idarubicin; TX, stem cell transplantation; w/o, without; BM, bone marrow; RA, refractory anemia; RAEB, with excess of blasts; IPSS, International Prognostic Scoring System; VGPR, very good partial response; and ß2MG, beta-2 microglobulin.
See also Table 2 for tetramer assay results in detail.
Assessed 3 weeks after the last vaccination.