Idiotypic vaccination as therapy for multiple myeloma.

Although advances in the treatment of multiple myeloma have been made using high-dose chemotherapy with subsequent autologous stem-cell transplantation, recurrence of the underlying disease almost invariably occurs. One proposed strategy to increase survival is tumor-specific activation of the immune system via idiotypic protein vaccination. Current issues to be resolved in the development of this approach include optimal vaccine formulation, appropriate assays to monitor treatment results, and timing of vaccine administration. Several clinical trials of idiotypic vaccines are currently being conducted in the United States and Europe. Initial results support the use of these vaccines as adjunct therapy in patients with multiple myeloma after high-dose chemotherapy and transplantation.