Immunotherapy for non-Hodgkin's lymphoma

The first attempt at using monoclonal antibodies in lymphoma therapy, reported in 1980, was unsuccessful. Since that time, several immunotherapeutic approaches to treating non-Hodgkin's lymphoma have been developed, with varying degrees of success. These approaches are largely based on the fact that each lymphoma is a clone of identical cells with a unique immunoglobulin on its surface. This unique portion of the immunoglobulin--the idiotype--is an ideal target for therapy. Clinical trials with antibodies have mostly targeted CD20, which is present on 95% of all B-cell lymphomas, as well as CD19 and CD22. This concept of using the idiotype to broaden the antilymphoma effect and to use it as a vaccine model has recently been evaluated. This approach would theoretically produce an active immunization with induction of humoral and cellular responses that would be longer acting than passive antibodies alone. The response is heterogeneous and polyclonal, which may be an advantage. Studies of these approaches will be outlined in this article.