Prior to the infusion of our selected and modified T-cell lines we will perform a myeloablation, the destruction of immune cells in the body by high dose full body radiation treatment and the infusion of hematopoietic stem cells (Wrzesinski et al 2010). This pre treatment of patients has been shown to greatly improve the efficacy of ACT treatments in vivo(Perica et al 2015). This works by reducing the presence of suppressing regulatory lymphocytes that inhibit cytotoxic T-cell activity(Wrzesinski et al 2010). We would infuse both our adaptive cell lines and our chimeric cell lines at the same time following the myeloablation and would concurrently administer IL-2 by and IV (Kochenderfer et al 2012). After the administration of the treatment we would monitor the patient and be on alert for cytokine toxicity a potential side effect of T-cell adaptive therapies caused by T-cell stimulated release of inflammatory cytokines. This can lead to fever and inflammation in the patient and can in very severe cases cause patient death (Barrett et al 2013). For dosage of the treatment, T-cell numbers are a limiting factor in the treatment. So we would infuse all the T-cells we are able to generate in a reasonable amount of time (maybe a month or two of growth), this amount would vary depending on multiple factors.
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