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Vaccine therapies for Non-Hodgkin’s Lymphoma

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Opinion statement

Various clinical observations suggest that non-Hodgkin’s lymphomas (NHLs), particularly those of low histologic grade, can be controlled by immunologic mechanisms. Although many effective therapies exist for the initial treatment of low grade lymphomas, none are curative and most have significant toxic side effects. Several promising lymphoma tumor antigen vaccines are being studied at medical centers throughout North America. I favor the scientific evaluation of a therapeutic strategy for follicular NHL that places immune-based therapies forward in the treatment algorithm to the initial therapeutic decision point. Active immunotherapies (therapeutic tumor vaccines) are instituted in tandem with initial cytoreductive chemotherapy, and followed by passive monoclonal antibody therapies. The tumorspecific idiotype vaccines are favored because of their demonstrated potential for clinical activity in numerous human studies and their lack of significant toxic side effects. Rituximab and other monoclonal antibodies directed at normal B-cell antigens are known to abrogate the host’s ability to mount primary humoral immune responses, including antitumor antibodies evoked by tumor vaccines. Therefore, one should consider deferring the use of these agents until after an attempt at generating a host humoral antitumor response using investigational tumor vaccines. Chemotherapy regimens containing highly immunosuppressive agents (ie, fludarabine) or organ dose-limiting toxicities (ie, doxorubicin) may be best reserved for later in the disease course for those failing the more conservative approaches and for cases with adverse prognostic features. This strategy may give patients the greatest chance at prolonged remission or cure while minimizing acute and chronic toxicities, although its impact on overall survival has not been proven. Low grade NHLs remain the proving ground for this treatment philosophy. Hopefully, in the future, similar strategies may be applicable to NHLs of other grades and histologies.

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References and Recommended Reading

  1. Timmerman JM, Levy RL: The history of the development of vaccines for lymphoma. Clin Lymphoma 2000, 1:129–139.

    Article  PubMed  CAS  Google Scholar 

  2. McLaughlin P, Grillo-Lopez AJ, Link BK, et al.: Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncol 1998, 16:2825–2833.

    PubMed  CAS  Google Scholar 

  3. Borrello I, Sotomayor EM, Rattis FM, et al.: Sustaining the graft-versus-tumor effect through posttransplant immunization with granulocyte-macrophage colony-stimulating factor (GM-CSF)-producing tumor vaccines. Blood 2000, 95:3011–3019.

    PubMed  CAS  Google Scholar 

  4. Wierda WG, Cantwell MJ, Woods SJ, et al.: CD40-ligand (CD154) gene therapy for chronic lymphocytic leukemia. Blood 2000, 96:2917–2924.

    PubMed  CAS  Google Scholar 

  5. Janetzki S, Palla D, Rosenhauer V, et al.: Immunization of cancer patients with autologous cancer-derived heat shock protein gp96 preparations: a pilot study. Int J Cancer 2000, 88:232–238.

    Article  PubMed  CAS  Google Scholar 

  6. Kwak LW, Campbell MJ, Czerwinski DK, et al.: Induction of immune responses in patients with B-cell lymphoma against the surface-immunoglobulin idiotype expressed by their tumors. N Engl J Med 1992, 327:1209–1215.

    Article  PubMed  CAS  Google Scholar 

  7. Hsu FJ, Benike C, Fagnoni F, et al.: Vaccination of patients with B-cell lymphoma using autologous antigen-pulsed dendritic cells. Nat Med 1996, 2:52–58.

    Article  PubMed  CAS  Google Scholar 

  8. Timmerman JM, Czerwinski DK, Davis TA, et al.: Idiotype-pulsed dendritic cell vaccination for B-cell lymphoma: clinical and immune responses in 35 patients. Blood 2002, 99:1517–1526.

    Article  PubMed  CAS  Google Scholar 

  9. Timmerman JM, Levy R: Dendritic cell vaccines for cancer immunotherapy. Annu Rev Med 1999, 50:507–529.

    Article  PubMed  CAS  Google Scholar 

  10. Bendandi M, Gocke CD, Kobrin CB, et al.: Complete molecular remissions induced by patient-specific vaccination plus granulocyte-monocyte colonystimulating factor against lymphoma. Nat Med 1999, 5:1171–1177.

    Article  PubMed  CAS  Google Scholar 

  11. Timmerman JM, Czerwinski D, Taid B, et al.: A phase I/II trial to evaluate the immunogenicity of recombinant idiotype protein vaccines for the treatment of non-Hodgkin’s lymphoma (NHL). Blood 2000, 96:578a.

    Google Scholar 

  12. Leukine [package insert]. Seattle, WA: Immunex. www.immunex.com.

  13. Zhu D, Rice J, Savelyeva N, Stevenson FK: DNA fusion vaccines against B-cell tumors. Trends Mol Med 2001, 7:566–572.

    Article  PubMed  CAS  Google Scholar 

  14. Timmerman JM, Singh G, Hermanson G, et al.: A phase I/II study of DNA idiotype vaccination for B-cell lymphoma. 92nd Annual Meeting of the American Association for Cancer Research. New Orleans, LA: March 24-28, 2001. Abstract 3759.

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Timmerman, J.M. Vaccine therapies for Non-Hodgkin’s Lymphoma. Curr. Treat. Options in Oncol. 3, 307–315 (2002). https://doi.org/10.1007/s11864-002-0030-3

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  • DOI: https://doi.org/10.1007/s11864-002-0030-3

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