Monoclonal anti-idiotype antibody therapy of B-cell lymphoma: the addition of a short course of chemotherapy does not interfere with the antitumor effect nor prevent the emergence of idiotype-negative variant cells

摘要: The Ig idiotype of B-cell lymphoma can be used as a tumor-specific target. Prior trials with monoclonal anti-idiotype antibodies alone and combined alpha-interferon have shown significant antitumor activity. In some patients, idiotype-negative tumors emerged after treatment. this trial, patients relapsed non-Hodgkin's were treated two identical courses anti-body therapy. Concurrent the second course, at time when cells suspected to proliferating, pulse dose chlorambucil was administered. Tumor biopsies obtained before first treatment relapse analyzed for expression proliferation. Thirteen received 24 antibody minimal toxicity. Eleven had tumor regression, 1 complete remission, 8 partial remissions, 2 minor freedom from progression lasting median 7 months in responding patients. Idiotype-negative appeared specimens despite use chlorambucil. retrospect, not surprising because there no increase proliferative rate these drug used. Anti-idiotype continue demonstrate activity against mechanism effect is presumed involve both direct antiproliferative effects on well indirect, more long-lasting host. addition mild chemotherapeutic agent schedule here cycle therapy did interfere effect, nor it decrease emergence cells.