ADOPTIVE CHEMOIMMUNOTHERAPY USING EX-VIVO ACTIVATED MEMORY T-CELLS AND CYCLOPHOSPHAMIDE - TUMOR LYSIS SYNDROME OF A METASTATIC SOFT-TISSUE SARCOMA

Adoptively transferred immune cells in combination with chemotherapeut ic agents form the basis for adoptive chemoimmunotherapy (ACIT) of neo plastic disease. Autolymphocytes (ALT-cells) are ex vivo activated per ipheral blood lymphocytes (PBL) from tumor-bearing hosts (TBH) that co nsist primarily of tumor-specific CD45RO+ (memory) T-cells. These ALT- cells combined with cimetidine (CIM) as autolymphocyte therapy (ALT), have previously been demonstrated to be a safe and active form of outp atient adoptive immunotherapy (AIT) in human TBH with metastatic renal cell cancer (RCC). We have previously described an effective ACIT pro tocol using ALT and cyclophosphamide (CY) for patients with relapsed a nd refractory non-RCC solid tumors. We now report a case of a patient with a metastatic gastric leiomyosarcoma to the liver, who-developed a clinical picture consistent with a tumor-lysis syndrome (TLS), follow ing salvage therapy for his tumor with ACIT using ALT and CY. TLS is a well-known complication resulting from the treatment of rapidly proli ferating hematopoietic tumors such as Burkitt's lymphoma and acute lym phocytic leukemia. TLS has also been rarely described in chronic lymph ocytic leukemia, as well as certain solid tumors such as breast cancer , small cell lung cancer, and medulloblastoma. However, there have bee n no previous reports of TLS occurring either secondary to immunothera py or in sarcomas. The nature of these unusual findings is discussed. (C) 1993 Wiley-Liss, Inc.