Prolonged survival associated with immune response in a patient treated with Lym-1 mouse monoclonal antibody

• Published in: Cancer biotherapy & radiopharmaceuticals Vol. 13; no. 1; p. 1
• Main Authors: DeNardo, S J, Kroger, L A, MacKenzie, M R, Mirick, G R, Shen, S, DeNardo, G L
• Format: Journal Article
• Language: English
• Published: United States 01-02-1998
• Subjects: Animals; Antibodies, Anti-Idiotypic - blood; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Female; Humans; Iodine Radioisotopes - therapeutic use; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; Leukemia, Lymphocytic, Chronic, B-Cell - immunology; Leukemia, Lymphocytic, Chronic, B-Cell - pathology; Leukemia, Lymphocytic, Chronic, B-Cell - radiotherapy; Mice; Middle Aged; Radioimmunotherapy; Radiopharmaceuticals - therapeutic use; Recurrence
• ISSN: 1084-9785
• DOI: 10.1089/cbr.1998.13.1

A patient with aggressive, chemotherapy-resistant non-Hodgkins lymphoma (NHL) was treated with 131I-Lym-1, a mouse antibody, on a protocol designed for serial therapy. Human anti-mouse antibody (HAMA) developed within 1 month of initial therapy. The patient also developed an antibody to the hypervariable region of the Lym-1 antibody (Lym-1 specific). Because the patient was responding to therapy, plasmaphoresis was used to reduce the level of HAMA followed by unlabeled Lym-1 calculated to be sufficient to block residual HAMA. This allowed additional therapy on three subsequent occasions over 5 months. Despite very high HAMA levels, no untoward effects from administrations of Lym-1 were observed. The HAMA response of the patient included anti-Lym-1 specific antibodies containing anti-idiotypic antibodies. The anti-Lym-1 antibody level has been sustained over the 9 year interval since 131I-Lym-1 therapy and has been associated with a uniquely long remission of the patient's disease. These observations demonstrate that, under certain circumstances, radioimmunotherapy (RIT) can be given safely and effectively despite HAMA. Anti-idiotypic antibodies could have induced an immune cascade that contributed to the prolonged disease-free survival of the patient.