Vacunación idiotípica en linfomas B de bajo grado: una nueva terapia antitumoral

Abstract

The immune system can be induced to mount a specific immune response against the individual idiotypic determinants expressed in the surface immunoglobulin of the B-cell lymphoma. Here we present the results of the first clinical trial of active idiotypic immunisation in patients with follicular low grade non-Hodgkin’s B-cell lymphoma conducted in Europe.Seven patients, most of them treated previously with chemotherapy and hemopoyetic transplant, received the vaccine consisting of their individual tumour Ig protein coupled to keyhole limpet hemocyanine and emulsified in an immunologic adjuvant. Five patients were in complete remission and two had residual disease before vaccination. Subjects were observed for toxicity, anti-idiotypic immune response and clinical outcome.The median duration of follow-up of all vaccinated patients since the initiation of immunotherapy is 23 (9–51) months. The 7 patients generated specific immune responses against the idiotypes of their tumour Ig. Two patients that had residual disease before vaccination experienced tumour regression, and one of them subsequently relapsed.We conclude that patients with low-grade B-cell lymphoma can be induced to mount a specific immune response against the Ig expressed by their own tumour, and that this kind of immunotherapy can be of benefit to patients affected by this disease. Facts that could correlate with a favourable clinical outcome are a complete clinical response before vaccination and the generation of a specific immune response.