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01.05.2005 | Leitthema

Immuntherapie maligner Non-Hodgkin-Lymphome

verfasst von: Dr. G. Heß

Erschienen in: Die Onkologie | Ausgabe 5/2005

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Zusammenfassung

Auch wenn in den vergangenen Jahren z. T. eine Verbesserung der Prognose von Non-Hodgkin-Lymphomen (NHL) bereits mit veränderten konventionellen und eskalierten Chemotherapieverfahren indolenter und aggressiver Lymphome erreicht werden konnte, verläuft für einen großen Teil der Patienten die Tumorerkrankung noch immer fatal. Da eine weitere Optimierung konventioneller Modalitäten schwer möglich erschien, stellte die Etablierung immuntherapeutischer Ansätze eine attraktive Option dar. Die erfolgreiche Einführung monoklonaler Antikörper in die Behandlung maligner Lymphome hat die Immuntherapie fest etabliert. Weiterentwicklungen dieses passiven Immuntherapieansatzes sind auf dem Weg in den klinischen Alltag. Daneben sind unterschiedliche Verfahren aktiver Immunisierung (Vakzinierung) in präklinischen und frühen klinischen Entwicklungen, deren Etablierung eine weitere Bereicherung des therapeutischen Armentariums darstellen kann. Zuletzt hat — insbesondere für Hochrisikopatienten — die allogene Stammzelltransplantation in der jüngsten Vergangenheit an Attraktivität gewonnen.
Literatur
1.
Zurück zum Zitat Bendandi M, Gocke CD, Kobrin CB et al. (1999) Complete molecular remissions induced by patient-specific vaccination plus granulocyte-monocyte colony-stimulating factor against lymphoma. Nat Med 10:1171–1177 Bendandi M, Gocke CD, Kobrin CB et al. (1999) Complete molecular remissions induced by patient-specific vaccination plus granulocyte-monocyte colony-stimulating factor against lymphoma. Nat Med 10:1171–1177
2.
Zurück zum Zitat Coiffier B, Haioun C, Ketterer N et al. (1998) Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with relapsing or refractory aggressive lymphoma: multicenter phase II study. Blood 92:1927–1932 Coiffier B, Haioun C, Ketterer N et al. (1998) Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with relapsing or refractory aggressive lymphoma: multicenter phase II study. Blood 92:1927–1932
3.
Zurück zum Zitat Coiffier B, Feugier P, Sebban C et al. (2004) Long term results of the GELA study, R-CHOP vs. CHOP in elderly patients with diffuse large B-cell-Lymphoma. Blood 103:1383a Coiffier B, Feugier P, Sebban C et al. (2004) Long term results of the GELA study, R-CHOP vs. CHOP in elderly patients with diffuse large B-cell-Lymphoma. Blood 103:1383a
4.
Zurück zum Zitat Coiffier B, Lepage E, Briere J et al. (2002) CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 346:235–242CrossRefPubMed Coiffier B, Lepage E, Briere J et al. (2002) CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 346:235–242CrossRefPubMed
5.
Zurück zum Zitat Czuczman MS, Grillo-López AJ, White CA et al. (1999) Treatment of patients with low-grade B-cell lymphoma with the combination of chimeric anti CD20 monoclonal antibody and CHOP chemotherapy. J Clin Oncol 17:268–276PubMed Czuczman MS, Grillo-López AJ, White CA et al. (1999) Treatment of patients with low-grade B-cell lymphoma with the combination of chimeric anti CD20 monoclonal antibody and CHOP chemotherapy. J Clin Oncol 17:268–276PubMed
6.
Zurück zum Zitat Czuczman MS, Weaver R, Alkuzweny B et al. (2004) Prolonged clinical and molecular remission in patients with low-grade or follicular non-Hodgkin’s lymphoma treated with rituximab plus CHOP chemotherapy: 9-year follow-up. J Clin Oncol 22:4659–4664 Czuczman MS, Weaver R, Alkuzweny B et al. (2004) Prolonged clinical and molecular remission in patients with low-grade or follicular non-Hodgkin’s lymphoma treated with rituximab plus CHOP chemotherapy: 9-year follow-up. J Clin Oncol 22:4659–4664
7.
Zurück zum Zitat Davis TA, Maloney DG, Czerwinski DK et al. (1998) Anti-idiotype antibodies can induce long-term complete remissions in non-Hodgkin’s Lymphoma without eradicating the malignant clone. Blood 92:1185–1190 Davis TA, Maloney DG, Czerwinski DK et al. (1998) Anti-idiotype antibodies can induce long-term complete remissions in non-Hodgkin’s Lymphoma without eradicating the malignant clone. Blood 92:1185–1190
8.
Zurück zum Zitat Ehrlich P (1957) Über den jetzigen Stand der Karzinomforschung. In: The Collected Papers of Paul Ehrlich. Pergamon Press, London, UK, II, 550–557 Ehrlich P (1957) Über den jetzigen Stand der Karzinomforschung. In: The Collected Papers of Paul Ehrlich. Pergamon Press, London, UK, II, 550–557
9.
Zurück zum Zitat Lenz G, Dreyling M, Hoster E et al. (2005) Immunochemotherapy with Rituximab and Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). Journal of Clinical Oncology 23:1984–1992 Lenz G, Dreyling M, Hoster E et al. (2005) Immunochemotherapy with Rituximab and Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). Journal of Clinical Oncology 23:1984–1992
10.
Zurück zum Zitat Fisher RI, Dana BW, LeBlanc M et al. (2000) Interferon alpha consolidation after intensive chemotherapy does not prolong the progression-free survival of patients with low-grade non-Hodgkin’s lymphoma: results of the Southwest Oncology Group randomized phase III study 8809. J Clin Oncol 18:2010–2016 Fisher RI, Dana BW, LeBlanc M et al. (2000) Interferon alpha consolidation after intensive chemotherapy does not prolong the progression-free survival of patients with low-grade non-Hodgkin’s lymphoma: results of the Southwest Oncology Group randomized phase III study 8809. J Clin Oncol 18:2010–2016
11.
Zurück zum Zitat Hainsworth J, Litchy S, Grec FA et al. (2003) Scheduled Rituximab maintenance therapy versus Rituximab retreatment at progression in patients with indolent non-Hodgkin’s lymphoma (NHL) responding to single-agent Rituximab: a randomized trial of the Minnie Pearl Cancer Research Network. Blood 102:231a Hainsworth J, Litchy S, Grec FA et al. (2003) Scheduled Rituximab maintenance therapy versus Rituximab retreatment at progression in patients with indolent non-Hodgkin’s lymphoma (NHL) responding to single-agent Rituximab: a randomized trial of the Minnie Pearl Cancer Research Network. Blood 102:231a
12.
Zurück zum Zitat Herold M, Pasold R, Srock S et al. (2004) Results of a prospective randomized open label phase III study comparing Rituximab plus mitoxantrone, chlorambucile, prednisolone chemotherapy (R-MCP) versus MCP alone in untreated advanced indolent non-Hodgkin’s lymphoma (NHL) and mantle cell lymphoma. Blood 104:584a Herold M, Pasold R, Srock S et al. (2004) Results of a prospective randomized open label phase III study comparing Rituximab plus mitoxantrone, chlorambucile, prednisolone chemotherapy (R-MCP) versus MCP alone in untreated advanced indolent non-Hodgkin’s lymphoma (NHL) and mantle cell lymphoma. Blood 104:584a
13.
Zurück zum Zitat Ghielmini M, Schmitz SF, Cogliatti SB et al. (2004) Prolonged treatment with rituximab in patients with follicular lymphoma significantly increases event-free survival and response duration compared with the standard weekly x 4 schedule. Blood 103:4416–4423CrossRefPubMed Ghielmini M, Schmitz SF, Cogliatti SB et al. (2004) Prolonged treatment with rituximab in patients with follicular lymphoma significantly increases event-free survival and response duration compared with the standard weekly x 4 schedule. Blood 103:4416–4423CrossRefPubMed
14.
Zurück zum Zitat Hiddemann W, Dreyling MH, Forspointer R et al. (2003) Combined immunochemotherpy (R-CHOP) significantly improves time to treatment failure in first line therapy of follicular lymphoma. Results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). Blood 102:352a Hiddemann W, Dreyling MH, Forspointer R et al. (2003) Combined immunochemotherpy (R-CHOP) significantly improves time to treatment failure in first line therapy of follicular lymphoma. Results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). Blood 102:352a
15.
Zurück zum Zitat Hsu FJ, Caspar C, Czerwinski D et al. (1997) Tumor-specific idiotype vaccines in the treatment of patients with B-cell lymphoma: Long term results of a clinical trial. Blood 89:3129–3135 Hsu FJ, Caspar C, Czerwinski D et al. (1997) Tumor-specific idiotype vaccines in the treatment of patients with B-cell lymphoma: Long term results of a clinical trial. Blood 89:3129–3135
16.
Zurück zum Zitat Kaminiski MS, Tuck M, Estes J et al. (2005) 131I-tositumomab therapy as initial treatment for follicular lymphoma. N Engl J Med 352:441–449 Kaminiski MS, Tuck M, Estes J et al. (2005) 131I-tositumomab therapy as initial treatment for follicular lymphoma. N Engl J Med 352:441–449
17.
Zurück zum Zitat Kimby E (2002) Beyond immunochemotherapy: combinations of rituximab with cytokines interferon-alpha2a and granulocyte colony stimulating factor [corrected]. Semin Oncol 29 [2 Suppl 6] Kimby E (2002) Beyond immunochemotherapy: combinations of rituximab with cytokines interferon-alpha2a and granulocyte colony stimulating factor [corrected]. Semin Oncol 29 [2 Suppl 6]
18.
Zurück zum Zitat Maloney DG, Liles TM, Czerwinski DK et al. (1994) Phase I clinical trial using escalating single-dose infusions of chimeric anti-CD20 antibody (IDEC-C2B8) in patients with recurrent B-cell lymphoma: Blood 84:2457–2466 Maloney DG, Liles TM, Czerwinski DK et al. (1994) Phase I clinical trial using escalating single-dose infusions of chimeric anti-CD20 antibody (IDEC-C2B8) in patients with recurrent B-cell lymphoma: Blood 84:2457–2466
19.
Zurück zum Zitat Maloney DG, Grillo-López AJ, White CA et al. (1998) IDEC-C2B8 (Rituximab) anti-CD20 antibody therapy of patients with relapsed low-grade non-Hodgkin’s lymphoma. Blood 90:2188–2195 Maloney DG, Grillo-López AJ, White CA et al. (1998) IDEC-C2B8 (Rituximab) anti-CD20 antibody therapy of patients with relapsed low-grade non-Hodgkin’s lymphoma. Blood 90:2188–2195
20.
Zurück zum Zitat Marcus R, Imrie K, Belch A et al. (2005) CVP chemotherapy plus Rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood 105:1417–1423 Marcus R, Imrie K, Belch A et al. (2005) CVP chemotherapy plus Rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood 105:1417–1423
21.
Zurück zum Zitat McLaughlin P, Grillo-López AJ, Link BK et al. (1998) Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncol 16:2825–2833PubMed McLaughlin P, Grillo-López AJ, Link BK et al. (1998) Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncol 16:2825–2833PubMed
22.
Zurück zum Zitat Miller RA, Maloney DG, Warnke R et al. (1982) Treatment of B-cell lymphoma with monoclonal anti-idotype antibody. N Engl J Med 306:517–522 Miller RA, Maloney DG, Warnke R et al. (1982) Treatment of B-cell lymphoma with monoclonal anti-idotype antibody. N Engl J Med 306:517–522
23.
Zurück zum Zitat Morschhauser F, Huglo D, Martinelle G et al. (2004) Yttrium-90 Ibritumomab Tiuxetan for patients with relapsed/refractory diffuse large cell B-Cell Lymphoma not appropriate for autologous stem cell transplantation: Results of an Open-Label Phase II Trial. Blood 104:130a Morschhauser F, Huglo D, Martinelle G et al. (2004) Yttrium-90 Ibritumomab Tiuxetan for patients with relapsed/refractory diffuse large cell B-Cell Lymphoma not appropriate for autologous stem cell transplantation: Results of an Open-Label Phase II Trial. Blood 104:130a
24.
Zurück zum Zitat Morris E, Thomson K, Craddock C et al. (2004) Outcomes after alemtuzumab-containing reduced intensity allogeneic transplantation regimen for relapsed and refractory non-Hodgkin Lymphoma. Blood 104:3865–3871 Morris E, Thomson K, Craddock C et al. (2004) Outcomes after alemtuzumab-containing reduced intensity allogeneic transplantation regimen for relapsed and refractory non-Hodgkin Lymphoma. Blood 104:3865–3871
25.
Zurück zum Zitat Nadler LM, Stashenko P, Hard R et al. (1980) Serotherapy of patient with a monoclonal antibody directed against a human lymphoma-associated antigen. Cancer Res 40:3147–3154 Nadler LM, Stashenko P, Hard R et al. (1980) Serotherapy of patient with a monoclonal antibody directed against a human lymphoma-associated antigen. Cancer Res 40:3147–3154
26.
Zurück zum Zitat Osterborg A, Dyer MJS, Bunjes D et al. (1997) Phase II multicenter study of human CD52 antibody in previously treated chronic lymphocytic leukemia. J Clin Oncol 15:1567–1573 Osterborg A, Dyer MJS, Bunjes D et al. (1997) Phase II multicenter study of human CD52 antibody in previously treated chronic lymphocytic leukemia. J Clin Oncol 15:1567–1573
27.
Zurück zum Zitat Pfreundschuh M, Truemper L, Devinder G et al. (2004) First analysis of the completed Mabthera international (MINT) trial in young patients with low-risk diffuse large-B-cell lymphoma: addition of rituximab to a CHOP-like regimen significantly improves outcome of all patients with the identification of a very favorable subgroup with IPI=0 and no bulky disease. Blood 104: 157a Pfreundschuh M, Truemper L, Devinder G et al. (2004) First analysis of the completed Mabthera international (MINT) trial in young patients with low-risk diffuse large-B-cell lymphoma: addition of rituximab to a CHOP-like regimen significantly improves outcome of all patients with the identification of a very favorable subgroup with IPI=0 and no bulky disease. Blood 104: 157a
28.
Zurück zum Zitat Press OW, Appelbaum F, Ledbetter JA et al. (1981) Monoclonal antibody 1F5 (anti-CD-20) serotherapy of human B-cell lymphomas. Blood 69:584–591 Press OW, Appelbaum F, Ledbetter JA et al. (1981) Monoclonal antibody 1F5 (anti-CD-20) serotherapy of human B-cell lymphomas. Blood 69:584–591
29.
Zurück zum Zitat Press OW, Eary JF, Gooley T et al. (2000) A phase I/II trial of iodine 131 tositumomab (anti-CD20), etoposide, cyclophoshamide, and autologous stem cell transplantation for relapsed B-cell lymphomas. Blood 96:2934–2942 Press OW, Eary JF, Gooley T et al. (2000) A phase I/II trial of iodine 131 tositumomab (anti-CD20), etoposide, cyclophoshamide, and autologous stem cell transplantation for relapsed B-cell lymphomas. Blood 96:2934–2942
30.
Zurück zum Zitat Rohatiner A, Radford J, Deakin D et al. (2001) A randomized controlled trial to evaluate the role of interferon as initial and maintenance therapy in patients with follicular lymphoma. Br J Cancer 85:29–35 Rohatiner A, Radford J, Deakin D et al. (2001) A randomized controlled trial to evaluate the role of interferon as initial and maintenance therapy in patients with follicular lymphoma. Br J Cancer 85:29–35
31.
Zurück zum Zitat Rohatiner AZ, Gregory WM, Peterson B et al. (2002) A metaanalysis of randomised studies evaluation of the role of interferon alpha as treatment for follicular lymphoma. Proc ASCO 21:1053a Rohatiner AZ, Gregory WM, Peterson B et al. (2002) A metaanalysis of randomised studies evaluation of the role of interferon alpha as treatment for follicular lymphoma. Proc ASCO 21:1053a
32.
Zurück zum Zitat Stevenson FK, Ottensmeier CH, Johnson P et al. (2004) DNA Vaccines to attack cancer. PNAS 101:14646–14652 Stevenson FK, Ottensmeier CH, Johnson P et al. (2004) DNA Vaccines to attack cancer. PNAS 101:14646–14652
33.
Zurück zum Zitat Timmerman JM, Czerwinski DK, Davis TA et al. (2002) Idiotype-pulsed dendritic cell vaccination for B-cell lymphoma: clinical and immune responses in 35 patients. Blood 99:1517–1526CrossRefPubMed Timmerman JM, Czerwinski DK, Davis TA et al. (2002) Idiotype-pulsed dendritic cell vaccination for B-cell lymphoma: clinical and immune responses in 35 patients. Blood 99:1517–1526CrossRefPubMed
34.
Zurück zum Zitat van Besien K, Loberiza FR, Bajorunaite R et al. (2003) Comparison of autologous and allogeneic hematopoietic stem cell transplantation for follicular lymphoma. Blood 102:3521–3529 van Besien K, Loberiza FR, Bajorunaite R et al. (2003) Comparison of autologous and allogeneic hematopoietic stem cell transplantation for follicular lymphoma. Blood 102:3521–3529
35.
Zurück zum Zitat Vose JM, Wahl RL, Saleh M et al. (2000) Multicenter phase II study of iodine-131 tositumomab for chemotherapy-relapsed/refractory low-grade and transformed low-grade B-cell non-Hodgkin’s lymphomas. J Clin Oncol 18:1316–1323 Vose JM, Wahl RL, Saleh M et al. (2000) Multicenter phase II study of iodine-131 tositumomab for chemotherapy-relapsed/refractory low-grade and transformed low-grade B-cell non-Hodgkin’s lymphomas. J Clin Oncol 18:1316–1323
36.
Zurück zum Zitat Weidmann E, Hess G, Krause SW et al. (2004) Combination chemoimmunotherapy using Alemtuzumab, Fludarabine, Cyclophosphamide, and Doxorubicin (Campath-FCD) is an effective first-line regimen in peripheral T-cell lymphomas. Blood 104:2640a Weidmann E, Hess G, Krause SW et al. (2004) Combination chemoimmunotherapy using Alemtuzumab, Fludarabine, Cyclophosphamide, and Doxorubicin (Campath-FCD) is an effective first-line regimen in peripheral T-cell lymphomas. Blood 104:2640a
37.
Zurück zum Zitat Witzig TE, White CA, Wiseman GA et al. (1999) Phase I/II trial of IDEC-Y2B8 radioimmunotherapy for treatment of relapsed or refractory CD20(+) B-cell non-Hodgkin’s lymphoma. J Clin Oncol 17:3793–3803PubMed Witzig TE, White CA, Wiseman GA et al. (1999) Phase I/II trial of IDEC-Y2B8 radioimmunotherapy for treatment of relapsed or refractory CD20(+) B-cell non-Hodgkin’s lymphoma. J Clin Oncol 17:3793–3803PubMed
38.
Zurück zum Zitat Witzig TE, Gordon LI, Cabanillas F et al. (2002) Randomized controlled trial of yttrium-90-labeled ibritumomab tiuxetan radioimmunotherapy versus rituximab immunotherapy for patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin’s lymphoma. J Clin Oncol 20:2453–2463CrossRefPubMed Witzig TE, Gordon LI, Cabanillas F et al. (2002) Randomized controlled trial of yttrium-90-labeled ibritumomab tiuxetan radioimmunotherapy versus rituximab immunotherapy for patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin’s lymphoma. J Clin Oncol 20:2453–2463CrossRefPubMed
39.
Zurück zum Zitat Witzig TE, Flinn IW, Gordon LI et al. (2002) Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin’s lymphoma. J Clin Oncol 20:3262–3269 Witzig TE, Flinn IW, Gordon LI et al. (2002) Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin’s lymphoma. J Clin Oncol 20:3262–3269
Metadaten
Titel
Immuntherapie maligner Non-Hodgkin-Lymphome
verfasst von
Dr. G. Heß
Publikationsdatum
01.05.2005
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 5/2005
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-005-0869-6

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