Immunotherapy with monoclonal anti-idiotypic antibodies: Tumour reduction and lymphokine production

• Published in: Leukemia Research Vol. 15; no. 4; pp. 215 - 222
• Main Authors: Allebes, Wil, Knops, Ruth, Herold, Manfred, Huber, Christopher, Haanen, Clemens, Capel, Peter
• Format: Book Review Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 1991; Elsevier Science
• Subjects: Aged; Anti-idiotype antibodies; Antibodies, Anti-Idiotypic - therapeutic use; Antibodies, Monoclonal - therapeutic use; Biological and medical sciences; Biopterins - analogs & derivatives; Biopterins - biosynthesis; Complement System Proteins - metabolism; Female; Humans; immune complexes; Immunopathology; immunotherapy; Leukemia, Lymphocytic, Chronic, B-Cell - immunology; Leukemia, Lymphocytic, Chronic, B-Cell - therapy; Lymphokines - biosynthesis; Macrophage Activation; Medical sciences; Neopterin; Receptors, Fc - metabolism; Remission Induction; TNF alpha; Tumor Necrosis Factor-alpha - biosynthesis; tumour reduction; CD; Anti-idiotype antibodies; TNF alpha; MoAb; IFN gamma; IL-2; RIA; neopterin; immune complexes; B-CLL; C3; C4; FcR; immunotherapy; tumour reduction; PI; RFL; IC; Anti-id; Id; Ig; ELISA; Case study; Human; Treatment; Immunotherapy; Lymphoproliferative syndrome; Malignant hemopathy; Lymphokine; Monoclonal antibody; Result
• ISSN: 0145-2126; 1873-5835
• DOI: 10.1016/0145-2126(91)90123-B

A patient with a B-cell chronic lymphocytic leukaemia was treated with a murine IgG1 monoclonal anti-idiotypic antibody (MoAb anti-id). After a total of 773.2 mg MoAb anti-id had been administered with a maximum daily dose of 83.2 mg, 90% tumour reduction was established within 2 weeks. Although in vitro the tumour cells were stimulated by MoAb anti-id no signs of tumour cell activation were observed in vivo during therapy with MoAb anti-id. The rapid tumour reduction suggests that the proliferation-enhancing property of anti-id is not a contra-indication for immunotherapy. The FcR II receptors on the patients monocytes could interact with the IgG1 monoclonal used. MoAb anti-id administration induced strongly decreased platelet counts, dependent on the amount of serum idiotype that had to be cleared. Antibody administration activated the macrophage/monocyte system, reflected in the neopterin profile, resulting in TNF alpha production and simultaneously strong reductions of circulating tumour cells. The partial remission lasted 3 months, then the tumour reappeared. These data show that a straightforward therapy with MoAb anti-id, in itself, has a strong potential, but is not sufficient to eradicate the tumour permanently. Further study will be needed to improve the clinical results with this kind of therapy.