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Follicular NHL: From Antibodies and Vaccines to Graft-versus-Lymphoma Effects

Correspondence: David Maloney, MD, PhD, Fred Hutchinson Cancer Rsch. Ctr., 1100 Fairview Ave. N, D1-100, Seattle, WA 98109; phone (206) 667-5616; fax (206) 667-6124; dmaloney{at}fhcrc.org

Abstract

Monoclonal antibody therapy with rituximab in combination with standard chemotherapy has improved the survival of patients with advanced-stage follicular lymphoma (FL). A series of next-generation anti-CD20 antibodies may be less immunogenic and have even greater antitumor activity through augmented interactions with host effector mechanisms responsible for tumor cell kill. Additional approaches with patient-specific immunoglobulin idiotype vaccines; novel monoclonal antibodies binding to biologically active cell-surface antigen are also demonstrating early clinical activity. Antibodies targeting radioisotopes, toxins or drugs are also slowly entering clinical trials and practice. Last, allogeneic stem cell transplantation following reduced-intensity conditioning provides graft-versus-tumor immune responses that may be able to control FL and allow this risky but potentially curative treatment option to older patents or those with comorbidities.

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