Idiotype vaccination using dendritic cells after autologous peripheral blood progenitor cell transplantation for multiple myeloma
| Autor: | Karl G. Blume, Keith Stockerl-Goldstein, Susanne Auffermann-Gretzinger, Ranjani Rajapaksa, Arcangelo Liso, Ronald Levy, Claudia Benike, Edgar G. Engleman, Adrienne van Beckhoven, Volker L. Reichardt |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_treatment chemical and pharmacologic phenomena Hematopoietic stem cell transplantation Transplantation Autologous Immune system Antigen Immunoglobulin Idiotypes Antineoplastic Combined Chemotherapy Protocols medicine Humans Multiple myeloma Transplantation business.industry Vaccination Hematopoietic Stem Cell Transplantation Immunotherapy Leukapheresis Hematology Dendritic Cells Middle Aged medicine.disease Minimal residual disease Combined Modality Therapy Immunology Female business Multiple Myeloma |
| Zdroj: | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 6(6) |
| ISSN: | 1083-8791 |
| Popis: | The idiotype (Id) determinants on the multiple myeloma immunoglobulin can serve as tumor-specific antigens. An anti-Id immune response may stem the growth of the malignant clone. We report on 26 patients treated at our institution with high-dose chemotherapy and peripheral blood progenitor cell transplantation (PBPCT) and vaccinated with the Id protein. The patients received chemotherapy and PBPCT to establish a minimal residual disease state. After high-dose therapy, the patients received a series of monthly immunizations consisting of 2 intravenous infusions of dendritic cells (DCs) pulsed with either Id protein or Id coupled with keyhole limpet hemocyanin (KLH) as an immunogenic carrier protein, followed by subcutaneous boosts of Id-KLH conjugates. DCs were obtained in all patients from a leukapheresis product 3 to 9 months after PBPCT. Patients were observed for toxicity, immune responses, and tumor status. The DC infusions and the administration of Id-KLH boosts were well tolerated, with patients experiencing only minor and transient side effects. Of the patients, 24 of 26 generated a KLH-specific cellular proliferative immune response. Only 4 patients developed an Id-specific proliferative immune response. Three of these immune responders were in complete remission at the time of vaccination. A total of 17 patients are alive at a median follow-up of 30 months after transplantation. Id vaccination with autologous DCs is feasible for myeloma patients after transplantation. Id-specific cellular responses can be induced in patients who are in complete remission. Further studies are needed to increase the rate of anti-Id immune responses in patients who do not achieve complete remission.Biol Blood Marrow Transplant 2000;6(6):621-7. |
| Databáze: | OpenAIRE |
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