Biological therapy of B and T cell lymphoproliferative disorders

Biotherapy has consistently exhibited signifi cant activity in lymphoid malignancies. The fi rst report of a complete remission with a monoclonal antibody in 1982 was in a patient with follicular lymphoma. Interferon alpha (IFNα) became the fi rst biological approved for the treatment of malignancy in 1986, because of its activity in hairy cell leukemia, and for many years was used in the treatment of lymphoma. The fi rst monoclonal antibody approved for the treatment of a malignancy was the antiCD20 chimeric Mab rituximab, which has become a block-bluster drug since its approval in 1997. The fi rst immunotoxin to gain regulatory approval, denileukin diftitox was approved based on activity in T cell lymphoma. The anti-CD52 humanized Mab alemtuzumab was approved based on its activity in CLL. The fi rst two radiolabeled antibodies approved for cancer treatment were the anti-CD20 products Y-90 ibritumomab tiuxetan and I-131 tositumomab which are very active in the treatment of B cell lymphoma. Finally, it is widely anticipated that perhaps one or more of the patient-specifi c vaccines consisting of idiotype protein may become the fi rst tumor specifi c vaccines to receive regulatory approval as treatment for follicular lymphoma.