Anti-Idiotype Antibody Response after Vaccination Correlates with Better Overall Survival in Follicular Lymphoma.

Purpose Immunoglobulin idiotype (Id) is a clonal marker expressed by B cells. Lymphoma B cells express a unique Id which serves as an ideal target for immunotherapy. It has been shown that induction of anti-Id immune response through vaccination is associated with many clinical benefits, including tumor regression, molecular remission, and prolonged progression free survival (PFS). However, it is unknown if induced immune response is an independent predictor for overall survival (OS). Patients and Methods We analyzed 91 patients who were uniformly treated with CVP followed by idiotype vaccination as the first-line therapy. The induction of anti-Id immune response was evaluated and correlated with OS. Univariate and multivariate analyses were applied to select independent factors that predicted OS.

Results: Those patients who achieved a CR/CRu to CVP chemotherapy or produced anti-Id antibody after vaccination had longer survival than those who did not. At 10 years, OS was 90% and 68% for patients with or without a CR/CRu after CVP (p = 0.024); 90% and 69% for patients with or without tumor-specific antibody production, respectively (p = 0.027). In contrast, generation of anti-Id cellular response did not correlate with OS. Furthermore, CR/CRu to CVP and generation of anti-Id antibody response were the only two independent factors among those tested that were correlated with longer survival.

Conclusion: Generation of anti-Id antibody after active immunotherapy is an independent predictor for better OS in follicular lymphoma.