title: Induction of cellular immune responses in patients with stage-I multiple myeloma after vaccination with autologous idiotype-pulsed dendritic cells.
abstract: Idiotype vaccines have shown both biological efficacy and clinical benefit in lymphoma. Circulating idiotype proteins (Id) in multiple myeloma patients offer a suitable target for immunotherapy. So far, specific immune responses after vaccination with Ids have been evaluated mostly in advanced myeloma. We explored the potential of dendritic-cell (DC)-based immunotherapy in 9 patients with stage-I disease. Mature monocyte-derived Id-pulsed DCs and keyhole limpet hemocyanin (KLH) were administered at dose levels between 2 and 20×10⁶ cells. Patients received 5 immunizations every 4 weeks. A median number of 6.8×10⁶ DCs were administered per vaccination. Five out of 9 patients (56%) developed Id-specific T cells as showed in proliferation assays and 8 out of 9 patients (89%) showed specific T-cell-mediated cytokine release after Id stimulation. The cytokine-secretion did not show a distinct Th1-type or Th2-type pattern. The M protein dropped slightly in 3 out of 9 patients. We could show that DC-based Id vaccination is a feasible way of inducing specific T-cell responses in stage-I myeloma patients. Further trials are needed to increase the rate of responses and to define the role of DC-based vaccination in the era of new pharmacologic therapies.
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Dresden, Germany. christoph.roellig@uniklinikum-dresden.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Röllig
authors.forename: Christian
authors.initials: C
authors.lastname: Schmidt
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Marc
authors.initials: M
authors.lastname: Schmitz
authors.forename: Susanne
authors.initials: S
authors.lastname: Auffermann-Gretzinger
mesh_terms: D000328:Adult; D000368:Aged; D019496:Cancer Vaccines / Q000276:immunology* / Q000627:therapeutic use; D016207:Cytokines / Q000096:biosynthesis / Q000378:metabolism; D003713:Dendritic Cells / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006433:Hemocyanins / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D007130:Immunoglobulin Idiotypes / Q000276:immunology; D007136:Immunoglobulins / Q000097:blood / Q000276:immunology; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology* / Q000628:therapy*; D010266:Paraproteins / Q000032:analysis / Q000096:biosynthesis / Q000235:genetics; D013601:T-Lymphocytes / Q000276:immunology; D014182:Transplantation, Autologous
chemical_list: D019496:Cancer Vaccines; D016207:Cytokines; D007130:Immunoglobulin Idiotypes; D007136:Immunoglobulins; D010266:Paraproteins; D006433:Hemocyanins; C032808:keyhole-limpet hemocyanin