Prospects for the treatment of B cell tumors using idiotypic vaccination.

Manipulation of the immune system in order specifically to attack autologous tumor cell has been a distant goal, largely due to the poor definition of tumor-associated antigens. By focussing on B cell lymphomas which express a molecularly defined clonal marker, the idiotypic immunoglobulin, it has been possible to generate autologous anti-idiotypic responses which suppress individual tumors. Studies of the components of these responses are providing insight into host effector mechanisms which can be activated against tumors, and also into the many strategies adopted by the target cells in order to avoid such attack. Promising results in various animal models where tumor bearers can be treated by idiotypic immunization have led to the point where application of this approach to the treatment of certain categories of human B cell lymphoma can be considered.