Immunotherapy of multiple myeloma.
The failure of chemotherapy to cure a significant proportion of multiple myeloma (MM) patients and increasing knowledge of tumor immunology and MM biology have generated considerable interest in immunotherapy for this lethal disease. Immunotherapy for MM can be divided into three broad categories: passive antibody-mediated immunotherapy, active specific immunization (vaccination), and adoptive T-cell immunotherapy. Early clinical trials using anti-CD20 monoclonal antibodies (mAbs) have met with limited success so far but have also suggested that selected patient subgroups may benefit from this treatment. The availability of a truly tumor-specific antigen such as immunoglobulin idiotype, the recent demonstration that MM cells process and present idiotype to T lymphocytes, and formal evidence of an antitumor effect of idiotypic vaccination in follicular lymphoma provide the framework for applying idiotypic vaccination in MM. The ability to generate ex vivo functional dendritic cells has made it possible to fuse them with patients' MM cells, thus producing a different type of customized vaccine. Dendritic cells are also a pivotal reagent to generate ex vivo MM-specific cytotoxic T lymphocytes (CTLs) to be reinfused into the patient for adoptive immunotherapy. This review summarizes achievements in MM immunotherapy based on data reported since 1998.
Ruffini
P A
PA
Department of Experimental Transplantation and Immunology, Medicine Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
Kwak
L W
LW
D000951:Antigens, Neoplasm; D002986:Clinical Trials as Topic; D006801:Humans; D007167:Immunotherapy; D009101:Multiple Myeloma / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome
D000951:Antigens, Neoplasm