Targets Of GvM Effect

Several potential targets of the GvM effect have been proposed (Table 85.4). Previous studies have focused on targeting the immunoglobulin idiotype (Id) as a tumor antigen in myeloma, an approach that has also been used in B-cell non-Hodgkin's lymphoma.6667 Investigators have generated specific anti-Id T-cell responses in patients with myeloma after high-dose chemotherapy or autologous transplantation. Demonstrating that this approach can be adoptively transferred, immunization of the donor against the patient's Id protein has resulted in the development of Id-specific T-cell responses in recipients after allo-geneic transplantation.37 Studies are attempting to use this strategy in nonmyeloablative transplantation as well.

Table 85.4 Potential target antigens of the graft-versus-myeloma effect

Potential targets References

Targets identified by T cells

Idiotype 37

MUC-1 62

MAGE family 63

hTERT 64

Targets identified by SEREX

BCMA 65

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