title: Tumor antigen immunization of sibling stem cell transplant donors in multiple myeloma.
abstract: The unique antigenic determinants (idiotype (Id)) of the immunoglobulin secreted by myeloma tumor can serve as a tumor-specific antigen for active immunotherapy. Our objective was to induce tumor-specific T-cell immunity in bone marrow transplant (BMT) donors to enhance antitumor effects of allografts. We vaccinated five HLA-matched sibling donors with myeloma Id proteins isolated from recipient plasma before bone marrow harvest. Recipients were administered booster Id immunizations following transplantation. Vaccination induced donor Id and carrier-specific cellular and/or humoral immune responses. Two recipients died within 30 days of BMT from transplant-related complications. Id and carrier-specific T-cell responses were detected in all three remaining patients post-, but not pre-BMT and persisted for 18 months. All three surviving patients converted from partial to complete responses following BMT. Two of the three patients remain disease-free 7 years and 8 years after BMT, and the third died of renal failure after 5.5 years while in complete remission from myeloma. Our results suggest that myeloma Id vaccination induces specific T-cell immunity in healthy donors which may be transferable by BMT, is associated with prolonged disease-free survival of recipients, and may represent a general strategy to enhance graft-versus-tumor effect in other malignancies for which defined tumor-specific antigens exist.
authors.affiliation: Experimental and Transplantation Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Neelapu
authors.forename: N C
authors.initials: NC
authors.lastname: Munshi
authors.forename: S
authors.initials: S
authors.lastname: Jagannath
authors.forename: T M
authors.initials: TM
authors.lastname: Watson
authors.forename: R
authors.initials: R
authors.lastname: Pennington
authors.forename: C
authors.initials: C
authors.lastname: Reynolds
authors.forename: B
authors.initials: B
authors.lastname: Barlogie
authors.forename: L W
authors.initials: LW
authors.lastname: Kwak
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000008:administration & dosage* / Q000494:pharmacology; D019496:Cancer Vaccines / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D020350:Graft vs Tumor Effect / Q000187:drug effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D007109:Immunity / Q000187:drug effects; D007114:Immunization; D007130:Immunoglobulin Idiotypes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D035781:Siblings; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000951:Antigens, Neoplasm; D019496:Cancer Vaccines; D007130:Immunoglobulin Idiotypes