[Treatment of B-cell lymphoma with monoclonal anti-idiotype antibody].

It has been over 15 years since Eisen first suggested that immunoglobulin idiotype could serve as a tumor-specific antigen. Over 10 years ago, Stevenson pointed out that B cell malignancies would be ideal targets for the idiotype-directed immune responses because these tumors retain the idiotype molecule on their cell surface rather than secreting it. Since that time a number of studies with animal models have shown that either passive or active immune manipulation directed at cell surface idiotypic determinants could have therapeutic effects on B cell malignancies. In this paper we will summarize and update the results of our clinical trials with anti-idiotype antibodies in patients with B cell malignancies. The results indicate that anti-idiotype antibodies can have profound effects on tumors, causing regressions in the majority of the patients treated. In addition, these studies have revealed that human B cell tumors are idiotypically heterogeneous due to extensive V-region somatic mutation.