Abstract: |
Through careful clinical trials, a number of obstacles to effective therapy with monoclonal antibodies (mAbs) have been identified. New technologies, however, have continued to provide strategies to overcome many of these obstacles. Four approaches—mAbs can be used as mediators of immune effector function, anti-idiotype (anti-id) mAbs can both target unique surface immunoglobulins expressed on B-cell neoplasms and mimic an antigen triggering tumor immunity, mAbs can be directed against receptors that control tumor growth, and mAbs can serve as vehicles to carry cytotoxic agents—to the therapeutic use of mAbs have been developed. Among the most promising applications of mAb-based therapies are those that take advantage of multiple mechanisms of tumor killing, such as the use of radioconjugates in combination with high-dose chemotherapy and TBI prior to bone marrow transplantation (BMT), the use of mAb-based therapies to eliminate residual disease, and the use of mAbs to purge tumor cells from bone marrow prior to reinfusion after dose-intensive therapy. The immunophenotypic characterization of the various stages and lineages found during hematopoietic differentiation has formed the basis for the selection of therapeutic mAbs. Leukemia- and lymphoma-associated antigens, however, are neither tumor specific, nor are they always stage or lineage specific. Therefore, myelosuppression—that affects the treatment of leukemia greatly—is often associated with mAb therapy of hematologic malignancies. © 1995, Academic Press Inc. |