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 Blood, 4 June 2009, Vol. 113, No. 23, pp. 5743-5746.
Prepublished online as a Blood First Edition Paper on April 3, 2009; DOI 10.1182/blood-2009-01-201988.

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CLINICAL TRIALS AND OBSERVATIONS

Brief report

Anti-idiotype antibody response after vaccination correlates with better overall survival in follicular lymphoma

Weiyun Z. Ai1,2, Robert Tibshirani3, Behnaz Taidi2, Debra Czerwinski2, and Ronald Levy2

1 Department of Medicine, Division of Hematology and Oncology, University of California, San Francisco; and 2 Department of Internal Medicine, Division of Medical Oncology and 3 Department of Health Research and Policy, Stanford University School of Medicine, CA

Previous studies demonstrated that vaccination-induced tumor-specific immune response is associated with superior clinical outcome in patients with follicular lymphoma. Here, we investigated whether this positive correlation extends to overall survival (OS). We analyzed 91 untreated patients who received CVP chemotherapy (cyclophosphamide, vincristine, and prednisone) followed by idiotype vaccination. Idiotype proteins were produced either by the hybridoma method or by expression of recombinant idiotype-encoding sequences in mammalian or plant-based expression systems. We found that achieving a complete response/complete response unconfirmed (CR/CRu) to CVP and making an anti-idiotype antibody are 2 independent factors that each correlated with longer OS at 10 years (89% vs 68% with or without a CR/CRu, P = .024; 90% vs 69% with or without tumor-specific antibody production; P = .027). In the subset of patients who received hybridoma-generated vaccines, we found that anti-idiotype production was even more highly associated with superior OS (P < .002); this was the case even in patients with a partial response (PR) to CVP (P < .001).


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