B Cell Lymphoma, Follicular Lymphoma, Neoplasm
Conditions
Keywords
B-Cell Lymphoma, BCL- 2 Positive Tumor, Immunization, Induction Chemotherapy, Lymphoma Vaccine, Follicular Lymphoma, Tumor-Derived Immunoglobulin Idiotype
Brief summary
Patients undergo chemotherapy until remission is obtained, or disease has been stable for two cycles of chemotherapy, or progressive disease develops. Three to six months after completion of chemotherapy, patients who have achieved complete clinical remission or minimal disease status receive a series of 5 injections (given 1-2 months apart) of a vaccine consisting of 0.5 mg autologous tumor-derived immunoglobulin (Id) conjugated to KLH. The vaccine is administered with subcutaneous QS-21 as an immunological adjuvant....
Detailed description
The idiotype of the immunoglobulin on a given B cell malignancy (Id) can serve as a clonal marker, and a previous pilot study in lymphoma patients has demonstrated that autologous Id protein can be formulated into an immunogenic, tumor specific antigen by conjugation to a carrier protein (KLH) and administration with an emulsion-based adjuvant. The objectives of this study are: 1) to evaluate feasibility and toxicity of new vaccine formulations, and 2) to evaluate cellular and humoral immune responses against the unique idiotype of the patient's lymphoma. The goal of this study is to treat patients with follicular lymphomas to complete remission or minimal residual disease with chemotherapy. Six to twelve months after completion of chemotherapy, in an effort to reduce the relapse rate (by eradicating microscopic disease resistant to chemotherapy), patients will receive one of two new formulations of an autologous Id vaccine.
Interventions
DRUGId-KLH Vaccine
DRUGQS-21 (Stimulation-QS-21) Drug
Sponsors
National Cancer Institute (NCI)
Study design
Primary purpose
TREATMENT
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* INCLUSION CRITERIA: Sample size: up to 30 patients. Sex distribution: Male and female. Age: Patients must be greater than or equal to 18 years old. Patients must meet all of the following eligibility criteria: Tissue diagnosis of: follicular small cleaved cell or follicular mixed lymphoma with surface IgM, IgA, or IgG phenotype with a monoclonal heavy and light chain. Pathology slides must be submitted to the NIH Pathology Department for review. Stage III or IV lymphoma. A single peripheral lymph node of at least 2x2 to 3x3 cm size and accessible for biopsy/harvest. Karnofsky status greater than or equal to 70%. Life expectancy of greater than 1 year. Serum creatinine less than or equal to 1.5 mg/dl unless felt to be secondary to lymphoma. Bilirubin less than or equal to 1.5 mg/dl unless felt to be secondary to lymphoma or Gilbert's disease. SGOT/SGPT less than or equal to 3.5 x upper limit of normal. Ability to give informed consent. Ability to return to clinic for adequate follow-up for the period that the protocol requires. There are no gender or racial / ethnic restrictions on patient selection. This protocol is open to all genders and racial / ethnic groups.
Exclusion criteria
The presence of any
Countries
United States
Outcome results
None listed