Medicinski vjesnik, Vol. 39 No. (1-4), 2007.
Original scientific paper
Antibody response to intravesical klh instillation in patients with superfical transitional cell cancer of the urinary bladder
Carlos Winkler
Karl Friedrich Klippel
Abstract
The dynamics of the specific KLH-antibody production after intracutaneous and intravesical instillation was analysed. Nine patients (male n=7; female n=2 mean 68.6 years, range 47-75) with primary superficial carcinomas of the bladder, were intracutaneously immunized with 1 mg Keyhole Limpet Haemocyanin (KLH) after the complete resection of tumors. Treatment consisting of 20 mg KLH in 20 ml saline introduced intravesically was continued once a week during the next 6 weeks, then once a month during one year and finally once every two months during the next 2 years. Antibodies against KLH in patients' sera were determined by means of specially developed direct enzyme-linked immunosorbent assay (ELISA: according to H. von der Kammer, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany). Blood was taken for antibody-titer examination before the treatment and 8 weeks after the treatment. The KLH-antibody titer increased significantly after KLH therapy (Mann-Whitney-Test P=0.02) in bladder cancer patients, however the level varied considerably from patient to patient. Six out of 9 patients (67%) presented increased serum antibody titers to KLH after immunotherapy, 4 patients (44.4%) remained free of tumor during the established follow-up period of 10-45 months (median 30.7 months). One patient without increased antibody titer to KLH was free of tumor. Two patients however, suffered from tumor recurrence after the KLH course. Two patients presented tumor recurrence in spite of increased antibody titers. No evidence of tumor progression occurred in patients with recurrence after KLH therapy. Four out of 5 patients (80%) without tumor recurrence presented positive skin test. In patients with tumor recurrence, 50% of them had a negative skin test. 44.4% KLH-treated patients had tumor recurrence. The recurrence rate was 1.6. Time span of recurrence was 8.75 months. KLH instillation did not induce major side effects. Positive skin test reactivity and KLH antibody response were more commonly seen in responding patients (i.e. those who remained tumor-free after the therapy) than in non-responders. The production of KLH antibodies apparently is the biological response to the antigen stimulus of KLH.
Keywords
Keyhole-limpet hemocyanine; Antibody formation; Enzyme-linked immunosorbent assay (ELISA); Carcinoma, transitional cell; Urinary bladder neoplasms - therapy
Hrčak ID:
191343
URI
Publication date:
1.12.2007.
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