Prolonged idiotypic vaccination against follicular lymphoma.
During the last 2 decades, idiotypic vaccination has provided proof of principle of biological efficacy, clinical efficacy and clinical benefit in small follicular lymphoma trials. However, with the exception of anecdotal reports, most patients have received no more than 10 doses of their customised idiotype (Id) vaccine. Therefore, it is not known whether prolonged usage of idiotypic vaccination is safe. Since 2002, 18 previously treated patients with follicular lymphoma have received extended idiotypic vaccination at our institution outside clinical trials. Vaccination was provided as a compassionate alternative to no further treatment, and was meant to be stopped only upon complete consumption of the available patient- and tumor-specific vaccine [Id-keyhole limpet hemocyanin + granulocyte-macrophage colony-stimulating factor (Id-KLH + GM-CSF)], or in case of disease relapse or any serious non-local toxicity. So far, 18 patients have received an average of 18 doses of Id vaccine (median: 17; mean: 18; range: 10-31). Eleven patients are still actively receiving idiotypic vaccination: some of them are now over more than 6 years. Toxicity has been systematically negligible and mostly local. No patient has abandoned the vaccination program because of toxicity. Prolonged idiotypic vaccination with the soluble protein Id-KLH + GM-CSF formulation is safe and well tolerated.
Inoges
Susana
S
Laboratory of Immunotherapy, Oncology Division, Center for Applied Medical Research, University of Navarra, Pamplona, Spain.
Lopez-Diaz de Cerio
Ascension
A
Zabalegui
Natalia
N
Soria
Elena
E
Villanueva
Helena
H
Panizo
Carlos
C
Rodriguez-Caballero
Arancha
A
Suarez
Lilia
L
Pastor
Fernando
F
Rodriguez-Calvillo
Mercedes
M
Orfao
Alberto
A
Bendandi
Maurizio
M
D000328:Adult; D019496:Cancer Vaccines / Q000009:adverse effects / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007130:Immunoglobulin Idiotypes / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use*; D008224:Lymphoma, Follicular / Q000276:immunology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014611:Vaccination
D019496:Cancer Vaccines; D007130:Immunoglobulin Idiotypes