Long-term follow-up of idiotype vaccination in human myeloma as a maintenance therapy after high-dose chemotherapy
Autor: | Mario Boccadoro, Sara Mariani, Massimo Massaia, Silvano Battaglio, Alessandro Pileri, Marta Coscia, C. Di Bello, F. Fiore, Myriam Foglietta |
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Rok vydání: | 2003 |
Předmět: |
Idiotype
Oncology Cancer Research medicine.medical_specialty Antibodies Neoplasm Injections Subcutaneous medicine.medical_treatment Receptors Antigen T-Cell High dose chemotherapy Adjuvants Immunologic Immunoglobulin Idiotypes Maintenance therapy hemic and lymphatic diseases Internal medicine Immunopathology Antineoplastic Combined Chemotherapy Protocols medicine Humans Hypersensitivity Delayed Glucocorticoids Neoplasm Staging Retrospective Studies Immunity Cellular Chemotherapy Hematology business.industry Remission Induction Vaccination Hematopoietic Stem Cell Transplantation Granulocyte-Macrophage Colony-Stimulating Factor Interferon-alpha Immunotherapy Middle Aged Combined Modality Therapy Antibodies Anti-Idiotypic Survival Rate Treatment Outcome Case-Control Studies Hemocyanins Immunology Multiple Myeloma business Follow-Up Studies |
Zdroj: | Leukemia. 18:139-145 |
ISSN: | 1476-5551 0887-6924 |
Popis: | The aim of this work was to evaluate the long-term immunological and clinical impact of idiotype (Id) vaccination in multiple myeloma (MM) patients in first remission after high-dose chemotherapy. A total of 15 patients received a series of subcutaneous (s.c.) injections of autologous Id, conjugated to keyhole limpet hemocyanin (KLH) and in association with low doses of GM-CSF. The median duration of follow-up was 110 months from diagnosis. The vaccine induced immune responses that lasted almost 2 years after the end of treatment. Antibody responses included anti-KLH IgM and IgG (90% of patients), anti-KLH IgE (30%), anti-GM-CSF IgG (20%), anti-Id IgG (20%), and anti-Id IgE (30%). Id-specific delayed type hypersensitivity skin tests were positive in 85% of tested patients. Following vaccination, a progressive recovery of T-cell receptor (TCR) diversity was observed and the loss of oligoclonality was significantly correlated with the remission duration. Although Id/KLH conjugates did not eliminate the residual tumor burden, the median progression-free survival, and overall survival were 40 and 82 months, respectively. A retrospective case-matched analysis showed similar results in patients treated with IFN-alpha alone or in association with steroids. This vaccine formulation can overcome Id-specific immune tolerance by inducing clinical responses that are worthy of further investigation. |
Databáze: | OpenAIRE |
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