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AUTHORS: F.K. Stevenson, J. Campos-Perez, S. Sahota, C. Ottensmeier
Molecular Immunology Group, Cancer Sciences Division, Tenovus Laboratory, Southampton University Hospitals Trust, Southampton, UK
by Lynne Lederman, PhD
Dr. Stevenson speculated that one day vaccination against myeloma might go hand-in-hand with drug therapy. Vaccination strategies are designed to engage the immune system to suppress the growth of myeloma cells by generation of specific anti-myeloma antibodies and/or cytotoxic T cells. Advantages of vaccination include the ability to induce remission, recover immune function, possible vaccination of donors of allogeneic stem cells for transplantation, and that myeloma cells are accessible to both antibodies and immune T cells. Disadvantages to this approach include the time it takes to develop vaccines and mount an immune response, myeloma is immunosuppressive, and few patients have a matched allogeneic donor. Patients with myeloma are able to respond to respond to tetanus toxoid after autologous stem cell transplantation (SCT), so it is possible to restore immune function. Strategies are being developed in other cancers, e.g., lymphoma and prostate cancer, and may be employed for myeloma vaccines. DNA vaccines rely on CpG repeats not frequent in the mammalian genome but present in bacteria to activate innate immunity, antigen molecules to elicit CD4 and CD8 cells, and microbial sequences to activate helper T cells and break tolerance. Identification of the most appropriate target antigens in myeloma will be crucial; two possibilities incld cancer testis antigen and NY[ESO 1 antigen.