Who can enter
- Children and teenagers with B-cell non-Hodgkin lymphoma (B-NHL) who had not previously received therapy.
- Age: Up to 18 years old.
Goal
The goal of this study is to investigate if anti-CD20 IgA treatment can efficiently stimulate immune cells to eliminate lymphoma cells.
Background
The drug rituximab has been used successfully to treat non-Hodgkin lymphoma of the B cell type in adults and children. Rituximab is a monoclonal antibody (produced in a laboratory) directed against the protein CD20. This protein is present on the surface of a wide range of B cells, both benign and malignant.
Although treatment with rituximab works well in children, long-term adverse effects appear to occur more frequently than in adults. For example, B cells may be absent for long periods of time, making children more susceptible to infections. This is probably because rituximab remains in the body for a long time, being an IgG type antibody.
IgA type antibodies can act quicker and better than IgG antibodies, and remain in the body for a shorter period of time. We expect this will result in less adverse effects. An anti-CD20 antibody of the IgA type might be very effective in eliminating malignant B cells, while the quick clearance from the body allows for healthy B cells to recover properly. Thus there is a smaller chance of long-term adverse effects.
In this study, we would like to co-culture lymphoma cells and anti-CD20 IgA antibody in the lab and see if the lymphoma cells can then be killed by the patient's immune cells. To do so, we will need to collect a single blood sample prior to the start of chemotherapy. In addition, we will use the patient's lymphoma cells if available (from the lymph node biopsy taken earlier). If the results of this study are promising, this innovative antibody therapy could be developed further for use in the clinic. Ultimately, this may lead to a more effective antibody therapy with fewer adverse effects for children with B-cell non-Hodgkin lymphoma.