THERAPY OF RECURRENT HIGH-GRADE GLIOMAS WITH SURGERY, AND AUTOLOGOUS MITOGEN ACTIVATED IL-2 STIMULATED KILLER (MAK) LYMPHOCYTES .1. ENHANCEMENT OF MAK LYTIC ACTIVITY AND CYTOKINE PRODUCTION BY PHA AND CLINICALUSE OF PHA

Nineteen patients with recurrent high grade gliomas were treated in a phase I/II trial with aggressive debulking of the tumor, mitogen activ ated IL-2 stimulated peripheral blood lymphocytes (MAK cells), and rIL -2. Phytohemagglutin (PHA) was introduced into the tumor site in 16 pa tients prior to implanting MAK cells and IL-2 in an attempt to trigger more effective lysis of the tumor in vivo. In vitro both TNF bioactiv ity and cytolytic activity of long term cultured MAK (LMAK) cells were dramatically enhanced by adding PHA to the cultures of these activate d PBL. Three of eleven patients (27%) had a decrease in size of the en hancing lesion on CT and/or MRI. Seven (37%) patients clinically impro ved. Median survival after therapy was 30 weeks. PHA was shown to be s afe in vivo and more effective than IL-2 triggering enhanced effector function in vitro.