IDIOTYPE VACCINATION AFTER BMT FOR B CELL MALIGNANCIES

该试验评估了配制新型疫苗以刺激抗肿瘤免疫应答并为已完成干细胞拯救高剂量治疗的B细胞恶性肿瘤患者提供治疗益处的可行性。每月一次的疫苗包括两次自体外周血树突细胞（专职抗原呈递细胞）治疗，通过单采收集，用个体化肿瘤独特型作为靶点进行脉冲并重新输注，然后皮下注射五剂与ISAF佐剂中的KLH偶联的独特型。4名非霍奇金淋巴瘤患者和26名多发性骨髓瘤患者已完成疫苗接种。另有7名患者正在接受疫苗接种，另有几名患者计划很快开始接种。树突状细胞的收集已经足够，并且输注已经非常好地耐受，几乎没有毒性。三名淋巴瘤患者在接种疫苗后出现体液和/或细胞增殖反应。26例骨髓瘤患者中有3例在接种疫苗后发生了细胞增殖反应;这种反应与高剂量治疗和干细胞移植后达到完全肿瘤反应显著相关。在同种异体移植环境中使用这些免疫方法的可能性的评估已经到位。

This trial evaluates the feasibility of formulating a novel vaccine to stimulate anti-tumor immune responses and provide therapeutic benefit for patients with B cell malignancies who have completed high dose therapy with stem cell rescue. The monthly vaccines consists of two treatments with autologous peripheral blood dendritic cells (professional antigen presenting cells) collected by apheresis, pulsed with individualized tumor idiotype as target and reinfused, followed by five doses of idiotype coupled to KLH in an ISAF adjuvant injected subcutaneously. Four patients with non-Hodgkin's lymphoma and 26 patients with multiple myeloma have completed the vaccination course. An additional seven patients are in the process of being vaccinated and several more are scheduled to start soon. The dendritic cell collections have been adequate and the reinfusions have been very well tolerated with next to no toxicity. Three of the lymphoma patients developed humoral and/or cellular proliferative responses after vaccination. Three of the 26 myeloma patients developed cellular proliferative responses after vaccination; such responses were strikingly correlated with attainment of a complete tumor response following high dose therapy and stem cell transplant. Evaluation of the possiblity of using these immune approaches in the allotransplant setting is in place.