恶性淋巴瘤疫苗治疗的进展

Advance in the research of vaccines for treating malignant lymphomas

目前很多类型的恶性淋巴瘤(ML)如惰性淋巴瘤,通过放化疗尚不能治愈。免疫治疗是血液系统恶性肿瘤的主要治疗手段之一,一些单克隆抗体已被FDA批准用于ML的治疗。由于ML是一种克隆增殖性疾病,存在于B细胞表面的免疫球蛋白(Ig)和T细胞表面的T细胞受体(TCR)的可变区均为独特型(Id)即肿瘤特异性抗原,使独特型淋巴瘤疫苗的研制成为可能并为其良好的疗效奠定了基础。国内外对应用不同种类的疫苗治疗ML进行了大量基础和临床研究,试图为这部分患者找到根治的方案,其中蛋白疫苗已经完成Ⅲ期临床试验,结果显示出初步的疗效,不同类型的二代疫苗正在研发和试验中,文中综述了ML疫苗治疗的进展。

Currently,some types of malignant lymphoma（ML） still can not be cured by chemotherapy or radiotherapy,such as indolent lymphoma.Immunotherapy has now become an important part in therapies of hematologic malignancies.Several monoclonal antibodies have been approved by the FDA and are in widespread use for ML.ML is composed of clonal proliferation of lymphocytes.The variable regions of the immunoglobulin are expressed on the surface of malignant B cells,and the T cell receptor（TCR） on the surface of malignant T cells.These regions are idiotype（Id） which can serve as a tumor-specific marker for the malignant clone.Idiotype is the basis of the produce and efficacy of ML vaccines.Lots of basic and clinical studies for different ML vaccines have been performed to find out a radical regimen for ML.Protein vaccine had finished Ⅲ clinical trial and the results showed primary effect.Different kinds of secondary vaccines were in study and clinical trial.This article reviewed the advance in the research of vaccines for treating malignant lymphomas.