Our results confirmed that an interim PET/CT scan has limited prognostic value in patients with diffuse large B-cell lymphoma homogeneously treated with six cycles of R-CHOP-14 in a large prospective trial. At this point, interim PET/CT scanning is not ready for clinical use to guide treatment decisions in individual patients.

No abstract

Anti-IgE antibodies have been detected in sera of patients with an allergic disease where they might play a role in the regulation of (Ig)E-mediated reactions. Using a recombinant phage surface display expression system a combinatorial library of antibody heavy and light chains was constructed from peripheral blood mononuclear cells from an atopic donor immunized with tetanus toxoid. Screening of the library allowed the identification of a large number of phages displaying human monovalent antigen-binding fragments (Phab) against tetanus toxoid and IgE. Surprisingly, we found a high frequency of Phab against particular IgE myelomas that was comparable to the frequency found for Phab against tetanus toxoid. However, most of these Phab were directed to different idiotypic determinants, depending on the IgE myeloma used for the panning procedure. Nevertheless, two clones were found to have anti-isotypic specificity and were shown to react specifically with the CH2 domain of the IgE heavy chain.

The online version of this article has a Supplementary Appendix. BackgroundMantle cell lymphoma accounts for 6% of all B-cell lymphomas and is generally incurable. It is characterized by the translocation t(11;14) leading to cyclin D1 over-expression. Cyclin D1 is downstream of the mammalian target of rapamycin threonine kinase and can be effectively blocked by mammalian target of rapamycin inhibitors. We set out to examine the single agent activity of the orally available mammalian target of rapamycin inhibitor everolimus in a prospective, multicenter trial in patients with relapsed or refractory mantle cell lymphoma (NCT00516412). Design and MethodsEligible patients who had received a maximum of three prior lines of chemotherapy were given everolimus 10 mg for 28 days (one cycle) for a total of six cycles or until disease progression. The primary endpoint was the best objective response. Adverse reactions, progression-free survival and molecular response were secondary endpoints. ResultsThirty-six patients (35 evaluable) were enrolled and treatment was generally well tolerated with Common Terminology Criteria grade ≥3 adverse events (>5%) including anemia (11%), thrombocytopenia (11%) and neutropenia (8%). The overall response rate was 20% (95% CI: 8-37%) with two complete remissions and five partial responses; 49% of the patients had stable disease. At a median follow-up of 6 months, the median progression-free survival was 5.5 months (95% CI: 2.8-8.2) overall and 17.0 (6.4-23.3) months for 18 patients who received six or more cycles of treatment. Three patients achieved a lasting complete molecular response, as assessed by polymerase chain reaction analysis of peripheral blood. ConclusionsEverolimus as a single agent is well tolerated and has anti-lymphoma activity in relapsed or refractory mantle cell lymphoma.

These Fab fragments show potential for the development of a new generation of therapeutic anti-Rh D reagents.