title: Melan-A specific CD8+ T lymphocytes after hyperthermic isolated limb perfusion: a pilot study in patients with in-transit metastases of malignant melanoma.
abstract: OBJECTIVE
  Isolated limb perfusion (ILP) with hyperthermia is an effective treatment for in-transit metastases of malignant melanoma in the extremities. Preclinical studies have shown that hyperthermia may induce an immunogenic death of tumour cells. We therefore decided to study whether ILP may induce tumour-specific immune responses in the clinical setting.
  
  
  METHODS
  The number of Melan-A/Mart-1 specific CD8+ T cells, as well as other phenotypically different immune cells, was recorded in peripheral blood in 12 HLA-A2+ patients with in-transit metastases undergoing hyperthermic ILP with melphalan.
  
  
  RESULTS
  All patients underwent ILP without any complication and with an overall response rate of 83%. No substantial changes in the number of circulating T-cells, B-cells, NK-cells or monocytes were observed during follow-up. Four out of 12 patients showed an elevation of Melan-A+ CD8+ T-cells 4 weeks after ILP.
  
  
  CONCLUSIONS
  We here report our preliminary observations that a small increase in tumour-specific T-cells could be seen in a subpopulation of patients after ILP. However, much more work is necessary to fully delineate the systemic immune response to hyperthermic ILP.
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden. roger.olofsson@surgery.gu.se
authors.forename: Roger
authors.initials: R
authors.lastname: Olofsson
authors.forename: Erika
authors.initials: E
authors.lastname: Lindberg
authors.forename: Alex
authors.initials: A
authors.lastname: Karlsson-Parra
authors.forename: Per
authors.initials: P
authors.lastname: Lindnér
authors.forename: Jan
authors.initials: J
authors.lastname: Mattsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Andersson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology; D058965:MART-1 Antigen / Q000276:immunology*; D008297:Male; D008545:Melanoma / Q000276:immunology* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D010477:Perfusion; D010865:Pilot Projects; D012878:Skin Neoplasms / Q000276:immunology* / Q000473:pathology / Q000628:therapy; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*
chemical_list: D058965:MART-1 Antigen