Unfortunately, many will ultimately develop recurrence of their cancer. If residual lymphoma cells could be more easily detected in patients who appear to be in complete remission, additional therapy could be administered before patients develop lymphoma recurrence. A molecular test called the polymerase chain reaction (PCR) can detect lymphoma cells that cannot be seen under the microscope. These residual lymphoma cells cause recurrent lymphoma in patients who are in an apparent complete remission. Eradication of residual lymphoma cells is difficult and physicians have been trying to destroy them by a variety of treatments.
A vaccine is a substance that contains specific components that distinguish it as “foreign” to the body. The body’s immune system recognizes these specific components as “foreign” and activates the immune response against the foreign substance. Physicians at the National Cancer Institute have developed and tested a patient specific vaccine for treatment of patients with B-cell Lymphoma. The vaccine is derived from the lymphoma cells collected from each patient. The initial results of the vaccination program were recently reported in
Nature Medicine. Twenty patients with B-cell lymphoma who were in complete remission by standard tests have been treated with the vaccine. In all patients evaluated using PCR, the test was positive for lymphoma cells even though the cells could not be otherwise detected. After 4 monthly vaccinations, 8 of 11 patients cleared their blood of lymphoma cells. With a minimum follow-up of 22 months, only 2 of 20 patients have had recurrence of their lymphoma.
This study shows that a vaccine derived from the lymphoma cells of an individual patient can eliminate residual lymphoma cells. This approach is extremely promising for preventing recurrence of lymphoma in patients who have responded well to chemotherapy. (Nature Medicine, Vol 5, No 10, pp 1171-1177, 1999)
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