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Letter


Nature Medicine 11, 986 - 991 (2005)
Published online: 21 August 2005 | doi:10.1038/nm1290

Vaccine-induced tumor-specific immunity despite severe B-cell depletion in mantle cell lymphoma

Sattva S Neelapu1,5, Larry W Kwak1,5, Carol B Kobrin2, Craig W Reynolds3, John E Janik1, Kieron Dunleavy1, Therese White1, Linda Harvey2, Robin Pennington2, Maryalice Stetler-Stevenson1, Elaine S Jaffe1, Seth M Steinberg4, Ronald Gress1, Fran Hakim1 & Wyndham H Wilson1


The role of B cells in T-cell priming is unclear, and the effects of B-cell depletion on immune responses to cancer vaccines are unknown. Although results from some mouse models suggest that B cells may inhibit induction of T cell–dependent immunity by competing with antigen-presenting cells for antigens, skewing T helper response toward a T helper 2 profile and/or inducing T-cell tolerance1, 2, 3, 4, results from others suggest that B cells are necessary for priming as well as generation of T-cell memory5, 6, 7. We assessed immune responses to a well-characterized idiotype vaccine in individuals with severe B-cell depletion but normal T cells after CD20-specific antibody–based chemotherapy of mantle cell lymphoma in first remission. Humoral antigen- and tumor-specific responses were detectable but delayed, and they correlated with peripheral blood B-cell recovery. In contrast, vigorous CD4+ and CD8+ antitumor type I T-cell cytokine responses were induced in most individuals in the absence of circulating B cells. Analysis of relapsing tumors showed no mutations or change in expression of target antigen to explain escape from therapy. These results show that severe B-cell depletion does not impair T-cell priming in humans. Based on these results, it is justifiable to administer vaccines in the setting of B-cell depletion; however, vaccine boosts after B-cell recovery may be necessary for optimal humoral responses.


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