We have been striving toward a goal of using immunotherapy to prevent cancer relapse. One facet of this therapy is to stimulate specific immunity using cancer vaccines. However, tumors are heterogeneous and we hypothesize that the presence of cancer itself, cancer chemotherapy, or more aggressive therapies such as bone marrow transplants may be imuunosuppressive. If this is true, cancer vaccines will not be effective until we can overcome this immunosuppression. We hypothesize that immune stimulating cytokines may be useful for this purpose. If one uses a cancer vaccine strategy and it fails, it is unclear whether failure is due to the cancer vaccine itself or a more generalized lack of responsiveness to any vaccine. To overcome this problem, in this protocol we will test two vaccines which are well characterized and very immunogenic. Tetanus toxoid has been used for decades and almost all individuals have had this. KLH, a foreign protein has been used since the early 1970's to assess immune responses. The major advantage of KLH is that it tests immune response to an antigen that individuals have not had prior exposure to (a so-called antigen). We will use tetanus and KLH to answer a very basic question of whether cancer patients have enough immune competence to respond to proteins which are 100% immunogenic in normal donors. In this protocol, we will stratify patients by their disease type, the amount of standard chemotherapy, and whether or not they will have undergone stem cell transplantation. The role of the GCRC in this protocol would be to administer both vaccines which are given intramuscularly and subcutaneously, to monitor toxicity, and to collect blood samples required for research tests to assess immune response.
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