title: Idiotype immunization following high-dose therapy and autologous stem cell transplantation for non-Hodgkin lymphoma.
abstract: The treatment of low- and intermediate-grade subtypes of malignant lymphoma continues to evolve. Mantle cell lymphoma (MCL) accounts for 6% of all non-Hodgkin lymphoma (NHL) and is generally considered incurable. Although high response rates can be achieved with initial chemotherapy, median survival is only 3-4 years. Intensified consolidation with high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) has been reported to improve progression-free survival (PFS), but most patients eventually relapse. Indolent lymphoma accounts for 35% of all NHL and is associated with a median survival of 9 years. Similar to MCL, it is also generally considered incurable, and the PFS also appears to be improved following HDT/ASCT. We initiated a pilot study to evaluate idiotype (Id) vaccination following HDT and ASCT for patients with MCL, indolent, and transformed NHL to evaluate the ability of Id-keyhole limpet hemocyanin (KLH) to induce immune responses, and to evaluate overall survival (OS) and PFS. We treated 15 patients: 8 with MCL, 4 with follicular lymphoma, 1 with small lymphocytic lymphoma, and 2 with transformed lymphoma. After a median follow-up of approximately 6.3 years (range: 1-9), PFS and OS at 9.05 years from time of ASCT are 59% and 52%, respectively.
authors: Moores UCSD Cancer Center, Blood and Marrow Transplantation Division, University of California-San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093, USA.
authors: Peter R
authors: PR
authors: Holman
authors: Caitlin
authors: C
authors: Costello
authors: Margarida
authors: M
authors: deMagalhaes-Silverman
authors: Sue
authors: S
authors: Corringham
authors: Januario
authors: J
authors: Castro
authors: Edward D
authors: ED
authors: Ball
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006433:Hemocyanins / Q000008:administration & dosage*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous; D014611:Vaccination
chemical_list: D000276:Adjuvants, Immunologic; D006433:Hemocyanins; C032808:keyhole-limpet hemocyanin