FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Volume 312:1653-1658 June 27, 1985 Number 26 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

The surface immunoglobulin of B-cell neoplasms provides a specific point of attack for potential antibody therapy. The capacity of anti-idiotype antibody to home to the target neoplasm requires that the idiotype be unique and that it be expressed by every cell in the neoplastic clone. We describe the evolution of an altered idiotype in a follicular lymphoma that resulted in escape from laboratory detection by monoclonal anti-idiotype antibody. This was not due to the emergence of a second (biclonal) lymphoma, since all the neoplastic cells were otherwise identical both phenotypically and genotypically, as determined by flow cytometry and genomic DNA (Southern blot) hybridization, respectively. All cells expressed the same B-cell immunotype and bore a constant amount of IgMk. The demonstration of a single configuration of immunoglobulin-gene DNA confirmed monoclonality and established that the change in idiotype was not a result of new gene rearrangements but was more likely due to somatic mutation of the variable region--a process presumed to occur naturally in B cells. These data demonstrate the lability of idiotype expression and define a mechanism by which B-cell neoplasms may become unresponsive to anti-idiotype therapy.

This article has been cited by other articles:

• Longo, D. L. (2006). Idiotype vaccination in follicular lymphoma: knocking on the doorway to cure.. JNCI J Natl Cancer Inst 98: 1263-1265 [Full Text]  
• Sanchez, M.-L., Almeida, J., Gonzalez, D., Gonzalez, M., Garcia-Marcos, M.-A., Balanzategui, A., Lopez-Berges, M.-C., Nomdedeu, J., Vallespi, T., Barbon, M., Martin, A., de la Fuente, P., Martin-Nunez, G., Fernandez-Calvo, J., Hernandez, J.-M., Miguel, J. F. S., Orfao, A. (2003). Incidence and clinicobiologic characteristics of leukemic B-cell chronic lymphoproliferative disorders with more than one B-cell clone. Blood 102: 2994-3002 [Abstract] [Full Text]  
• Foon, K. A., Rai, K. R., Gale, R. P. (1990). Chronic Lymphocytic Leukemia: New Insights into Biology and Therapy. ANN INTERN MED 113: 525-539 [Abstract]  
• Dillman, R. O. (1989). Monoclonal Antibodies for Treating Cancer. ANN INTERN MED 111: 592-603 [Abstract]  
• CHAMPLIN, R., GALE, R. P., FOON, K. A., GOLDE, D. W. (1986). Chronic Leukemias: Oncogenes, Chromosomes, and Advances in Therapy. ANN INTERN MED 104: 671-688 [Abstract]