Bcell lymphoma is a cancer of the lymph glands caused by unruly growth of B cells, white blood cells that produce the body's disease-fighting antibodies. These proteins are then shed into a tissue culture fluid, from which researchers pluck out the particular protein of interest-a receptor molecule on the outer coating of B cells. And since it is unique to a given B cell, any tumor derived from that malignant B cell will have this marker. After obtaining the individual receptor molecule from each patient's tumor, the investigators couple it to a highly immunogenic carrier protein. Then, to provoke a vigorous immune response to these marked B cells, they also add an adjuvant or immune system booster.
T cells are the white blood cells that orchestrate the immune response.
Patients receiving the experimental vaccine are given an initial injection after 6 months of chemotherapy, followed by booster shots for 6 months. Because lymphomas can recur after many years in remission, Dr. Kwak and his colleagues have established surrogate endpoints to determine whether the new vaccine is working. Unlike conventional vaccines, which are used to prevent illness, the Bcell lymphoma vaccine represents a therapeutic approach, which seeks to strengthen the body's natural defenses against diseases that have already developed. For the current vaccine trials, NCI is urging physicians around the country to refer patients at the time of diagnosis, rather than after tumors have been removed or chemotherapy has begun. They can answer questions in English and Spanish and can send free printed material.