title: Active idiotypic vaccination in a patient with biclonal follicular lymphoma.
abstract: Specific immunological responses to the idiotypic epitopes present in the surface immunoglobulin (Ig) of the clonal tumour population can be induced for active immunotherapy in patients with B-cell non-Hodgkin lymphoma (NHL). The clonality of the tumour cells should have important implications for the success of the implemented therapy. Here we report on the case of a patient enrolled in a protocol of active idiotypic immunotherapy in which previous cytofluorometric analysis showed a major IgM+, kappap+ population in the tumoral cell suspensions. However, sequence analysis of both tumour sample and tumour-derived hybrids revealed the presence of two unrelated clones that used different VH and VK gene segments. It was possible to obtain hybridomas secreting these two different IgM, kappap idiotypic proteins. The patient was immunised with a mixture of these two idiotypic Igs conjugated to keyhole limpet haemocyanin. Anti-idiotypic antibodies directed against both tumour-associated proteins were detected. This is the first case of anti-idiotypic therapy in a patient with a biclonal NHL. Our work calls attention to the question of clonality in the context of idiotypic vaccination in NHL patients.
authors.affiliation: Department of Immunology, Hospital Clínica Puerta de Hierro, Madrid, Spain.
authors.forename: Y
authors.initials: Y
authors.lastname: Barrios
authors.forename: A
authors.initials: A
authors.lastname: Plaza
authors.forename: R
authors.initials: R
authors.lastname: Cabrera
authors.forename: R
authors.initials: R
authors.lastname: Yáñez
authors.forename: E
authors.initials: E
authors.lastname: Suárez
authors.forename: M N
authors.initials: MN
authors.lastname: Fernández
authors.forename: F
authors.initials: F
authors.lastname: Díaz-Espada
mesh_terms: D000328:Adult; D001483:Base Sequence; D019496:Cancer Vaccines / Q000627:therapeutic use*; D006433:Hemocyanins / Q000276:immunology; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007130:Immunoglobulin Idiotypes / Q000276:immunology*; D007135:Immunoglobulin Variable Region / Q000235:genetics; D007145:Immunoglobulin kappa-Chains / Q000235:genetics; D016233:Immunotherapy, Active; D008224:Lymphoma, Follicular / Q000628:therapy*; D008297:Male; D008969:Molecular Sequence Data
chemical_list: D019496:Cancer Vaccines; D007143:Immunoglobulin Heavy Chains; D007130:Immunoglobulin Idiotypes; D007135:Immunoglobulin Variable Region; D007145:Immunoglobulin kappa-Chains; D006433:Hemocyanins; C032808:keyhole-limpet hemocyanin