Houet Leonora, Veelken Hendrik
Department of Haematology/Oncology, Freiburg University Medical Center, Hugstetter Strasse 55, D-79106 Freiburg, Germany.
Eur J Cancer. 2006 Jul;42(11):1653-60. doi: 10.1016/j.ejca.2006.03.008. Epub 2006 Jun 22.
Since myeloma cells express various potential target antigens, active immunotherapy is being investigated as a novel treatment modality for myeloma. Immunization against the clonal myeloma immunoglobulin (idiotype) elicits protective immunity in mouse models. Idiotype vaccination of myeloma patients can induce cellular immunity, albeit as yet without firm evidence for improved clinical outcome. Other tumour-associated antigens (including cancer/testis antigens) are expressed with various frequencies in myeloma. T cells with specificity for these antigens may exist in myeloma patients, and immunization trials with some of these antigens are ongoing. Future studies need to identify the best antigen, the optimal vaccine formulation and schedule, and the preferable clinical situation for vaccination with myeloma antigens. In addition, immunization of stem cell donors with myeloma antigens may improve the efficacy and outcome of allogeneic stem cell transplantation through transfer of idiotype-directed immunity to the patient, and has already shown promising clinical results.
由于骨髓瘤细胞表达多种潜在的靶抗原，主动免疫疗法正作为一种新型的骨髓瘤治疗方式进行研究。针对克隆性骨髓瘤免疫球蛋白（独特型）的免疫接种在小鼠模型中可引发保护性免疫。骨髓瘤患者的独特型疫苗接种可诱导细胞免疫，尽管目前尚无确凿证据表明临床结局得到改善。其他肿瘤相关抗原（包括癌胚抗原）在骨髓瘤中以不同频率表达。对这些抗原有特异性的T细胞可能存在于骨髓瘤患者体内，针对其中一些抗原的免疫试验正在进行。未来的研究需要确定最佳抗原、最佳疫苗配方和接种方案，以及接种骨髓瘤抗原的最佳临床情况。此外，用骨髓瘤抗原对干细胞供体进行免疫接种，可能通过将独特型导向的免疫转移给患者，提高异基因干细胞移植的疗效和结局，并且已经显示出有希望的临床结果。
