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Gururangan et al. Neuroimmunol Neuroinflammation 2018;5:45 Neuroimmunology and
DOI: 10.20517/2347-8659.2018.44 Neuroinflammation

Review Open Access

Total tumor RNA pulsed dendritic cells plus adoptive
transfer of ex-vivo enriched autologous T-lymphocytes
in the treatment of children with primary brain tumors

Sridharan Gururangan, Elias Sayour, Duane A. Mitchell

Department of Neurosurgery, Preston A. Wells Center for Brain Tumor Therapy, McKnight Brain Institute, Gainesville, FL 32608, USA.

Correspondence to: Dr. Sridharan Gururangan, Department of Neurosurgery, Preston A. Wells Center for Brain Tumor Therapy,
McKnight Brain Institute, Gainesville, FL 32608, USA. E-mail: gururangan@ufl.edu
How to cite this article: Gururangan S, Sayour E, Mitchell DA. Total tumor RNA pulsed dendritic cells plus adoptive transfer of ex-vivo
enriched autologous T-lymphocytes in the treatment of children with primary brain tumors. Neuroimmunol Neuroinflammation 2018;5:45.
http://dx.doi.org/10.20517/2347-8659.2018.44
Received: 31 Jul 2018 First Decision: 24 Aug 2018 Revised: 21 Sep 2018 Accepted: 15 Oct 2018 Published: 29 Oct 2018

Science Editor: Athanassios P. Kyritsis Copy Editor: Cui Yu Production Editor: Zhong-Yu Guo

Abstract
The therapeutic approach of adoptive lymphocyte transfer (ALT) using lymphocytes primed and expanded ex-vivo
by exposure to total tumor RNA (ttRNA) containing dendritic cells (DCs) and administered after lymphodepletive
host conditioning in patients with refractory melanoma with brain metastases has shown excellent objective
responses indicating that the central nervous system (CNS) is not an immune privileged site and further paved the
way for utilization of a similar approach in other cancers. We have shown that the use of ALT + ttRNA DCs following
either myeloablative or non-myeloablative host conditioning is feasible and safe and appears to prolong survival
in a proportion of children with recurrent medulloblastoma who had failed standard cytotoxic therapy. Further
refinements in this promising approach are needed to improve outcomes and extend this treatment to a broad range
of CNS malignancies.

Keywords: Children, brain tumors, immunotherapy, adoptive lymphocyte transfer, dendritic cell vaccine,
lymphodepletion, total tumor RNA

INTRODUCTION
Primary pediatric central nervous system tumors
Pediatric brain tumors are the commonest solid tumors in children and unfortunately the cause for the
[1]
most cancer related mortality in this age group . Standard treatment for these patients at diagnosis includes

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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