This trial evaluates the ability of a novel vaccine to stimulate anti- tumor immune responses and proved therapeutic benefit in an adjuvant setting. The vaccine consists of autologous dendritic cells (professional antigen presenting cells) collected by apharesis, pulsed with individualized tumor idiotype, washed, and reinfused into the patient. Twenty-one patients with low grade non-Hodgkin's lymphoma have complete vaccination with four courses of idiotype pulsed autologous dendritic cells. The dendritic cell infusions have been very well tolerated with rare infusion reactions which are tolerable and easily controlled. There is no evidene of acute or chornic toxicity. Twelve of these 21 patients have developed measureable anti-idiotype T-cell proliferative responses, suggesting the possibility of an anti-tumor effect. Still no patients have produced measureable humoral anit- idiotype responses, unlike patients treated with our standard vaccine. This may be a true characteristic of the dendritic cell approach. Several patients did experience tumor regressions during and after dendritic cell vaccination. Nine of the 21 patients have developed progressive disease within several years of vaccination. These are patients with a poorer prognosis defined by suboptimal response to initial chemotherapy. As the trial continues to accrue, we will have a larger population whose clinical responses can be compared to the expected clinical course for comparable patients.
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