Guillain-Barré syndrome after adoptive cell therapy with tumor-infiltrating lymphocytes.

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State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_C930B13A53AD
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Guillain-Barré syndrome after adoptive cell therapy with tumor-infiltrating lymphocytes.
Journal
Journal for immunotherapy of cancer
Author(s)
Orcurto A., Hottinger A., Wolf B., Navarro Rodrigo B., Ochoa de Olza M., Auger A., Kuntzer T., Comte D., Zimmer V., Gannon P., Kandalaft L., Michielin O., Zimmermann S., Harari A., Trueb L., Coukos G.
ISSN
2051-1426 (Electronic)
ISSN-L
2051-1426
Publication state
Published
Issued date
08/2020
Peer-reviewed
Oui
Volume
8
Number
2
Pages
e001155
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Adoptive cell therapy (ACT) using tumor-infiltrating lymphocytes (TILs) is a promising experimental immunotherapy that has shown high objective responses in patients with melanoma. Current protocols use a lymphodepletive chemotherapy before infusion of ex vivo expanded TILs, followed by high-dose interleukin-2 (IL-2). Treatment-related toxicities are mainly attributable to the chemotherapy regimen and to the high-dose IL-2 and are generally reversible. Neurological side effects have rarely been described. Nevertheless, due to improvements in cell production techniques and due to combinations with other immunomodulating molecules, side effects not previously described may be encountered.
We report the case of a 53-year-old heavily pretreated patient with melanoma who developed Guillain-Barré syndrome (GBS) 19 days after ACT using autologous TILs, given in the context of a phase I trial. He presented with dorsal back pain, unsteady gait and numbness in hands and feet. Lumbar puncture showed albuminocytological dissociation, and nerve conduction studies revealed prolonged distal motor latencies in median, ulnar, tibial and peroneal nerves, compatible with a GBS. The patient was treated with intravenous immunoglobulins and intensive neurological rehabilitation, with progressive and full recovery at 21 months post-TIL-ACT. Concomitant to the onset of GBS, a cytomegalovirus reactivation on immunosuppression was detected and considered as the most plausible cause of this neurological side effect.
We describe for the first time a case of GBS occurring shortly after TIL-ACT for melanoma, even though we could not identify with certainty the triggering agent. The report of such rare cases is of extreme importance to build on the knowledge of immune cellular therapies and their specific spectrum of toxicities.
Keywords
adoptive, immunotherapy, lymphocytes, melanoma, tumor-infiltrating
Pubmed
Web of science
Open Access
Yes
Create date
09/09/2020 13:02
Last modification date
15/01/2021 7:24
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