Clinical outcome of lymphoma patients after idiotype vaccination is correlated with humoral immune response and immunoglobulin G Fc receptor genotype.

Abstract

PURPOSE:

The unique immunoglobulin idiotype (Id) expressed by each B-cell lymphoma is a target for immunotherapy. Vaccination with Id induces humoral and/or cellular anti-Id immune responses. However, the clinical impact of these anti-Id immune responses is unknown. We and others have previously reported that immunoglobulin G Fc receptor (FcgammaR) polymorphisms predict the clinical response of lymphoma patients to passive anti-CD20 antibody infusions. In this study, we tested whether anti-Id immune responses or FcgammaR polymorphisms associate with clinical outcome of patients who received Id vaccination.

PATIENTS AND METHODS:

We analyzed 136 patients with follicular lymphoma who had received Id vaccination. The anti-Id immune responses were measured and FcgammaRIIIa and FcgammaRIIa polymorphisms were determined and correlated with clinical outcome for these patients.

RESULTS:

Patients who mounted humoral immune responses had a longer progression-free survival (PFS) than those who did not (8.21 v 3.38 years; P = .018). Patients with FcgammaRIIIa 158 valine/valine (V/V) genotype also had a longer PFS than those with valine/phenylalanine (V/F) or phenylalanine/phenylalanine (F/F) genotypes (V/V, 8.21 v V/F, 3.38 years; P = .004; v F/F, 4.47 years; P = .035). Multivariate analysis using the Cox proportional hazards model showed that V/V genotype and humoral immune responses were independent positive predictors for PFS.

CONCLUSION:

This study is the first to identify the predictive value of FcgammaR polymorphism on clinical outcome in patients who received active immunotherapy with tumor antigen vaccines. Our results imply that the antibodies induced against a tumor antigen are beneficial and that FcgammaR-bearing cells mediate an antitumor effect by killing antibody-coated tumor cells.

• Authors: Wen-Kai Weng, Debra Czerwinski, John Timmerman, Frank J Hsu, Ronald Levy
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 22 Issue 23 Pg. 4717-24 (Dec 01 2004) ISSN: 0732-183X [Print] United States
• PMID: 15483014 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antigens, CD
• Fc gamma receptor IIA
• Genetic Markers
• Immunoglobulin Idiotypes
• Receptors, IgG

Topics

• Antigens, CD (genetics, metabolism)
• Cohort Studies
• Female
• Genetic Markers
• Humans
• Immunoglobulin Idiotypes (therapeutic use)
• Immunotherapy, Active (methods)
• Lymphoma, B-Cell (genetics, immunology, mortality, therapy)
• Lymphoma, Follicular (genetics, immunology, mortality, therapy)
• Lymphoma, Non-Hodgkin (genetics, immunology, mortality, therapy)
• Male
• Multivariate Analysis
• Polymorphism, Genetic
• Predictive Value of Tests
• Prognosis
• Proportional Hazards Models
• Prospective Studies
• Receptors, IgG (genetics, metabolism)
• Risk Assessment
• Sensitivity and Specificity
• Survival Analysis
• Treatment Outcome
• Vaccination (methods)