NON-HODGKINS-LYMPHOMA - A REVIEW OF IMMUNOTHERAPEUTIC APPROACHES TO TREATMENT

Non-Hodgkin's lymphomas (NHL) represent a heterogenous group of diseas es including low, intermediate and high grade histological subtypes. M ost entities are sensitive to chemotherapy and radiotherapy. However, most relapsed patients are incurable with conventional treatment. The major reason for unsatisfactory long-term results in NHL is tumour cel ls that persist after standard treatment, New sensitive techniques hav e been developed to detect occult lymphoma cells. These cells might be eradicated by new immunotherapeutic agents with different modes of ac tion, such as cytokines or antibody-based agents. In NHL, most experie nce has been accumulated with interferon-alpha, which seems to be effe ctive against minimal residual disease (MRD). The experience with inte rleukin-2 and interleukin-3 is less convincing. Monoclonal antibodies have been used in their native form, or conjugated with radioisotopes or toxins to selectively destroy lymphoma cells. Such immunotoxins and radioisotope-coupled antibodies have shown promising results in early clinical trials, and are now being evaluated in patients with smaller tumour burdens.