BACKGROUND Autologous stem-cell transplantation has proved curative therapy for relapsed NHL. However, recurrence of underlying disease remains the major cause of treatment failure in this setting. METHODS Development of effective MAb therapy directed against the B cell surface antigen CD20 has added a valuable tool of clearing contaminating lymphoma cells from stem-cell products by either in vitro or in vivo application. RESULTS Transplantation of successfully in vitro purged bone marrow using Mabs has been correlated with prolonged survival in large Phase-II study. So far, no randomized trial could demonstrate a therapeutic benefit for in vitro purging. The anti-CD20 Mab rituximab has been used for in vivo purging at the time of stem cell collection or peritransplantation. This method has been shown to be safe and feasible. In the majority of patients the combination of rituximab with anti-lymphoma chemotherapy meant the collected stem cell products were free of molecularly-detectable lymphoma cells. DISCUSSION The increasing ability to kill all lymphoma cells in vivo by regimens including myeloablative therapy renders contaminating lymphoma cells of the autologous stem cell product the main source for disease recurrence. Clearing of these cells remains a prerequisite for curative stem-cell transplantation. Establishment of safe and effective therapeutic schedules using Mabs will enhance the chance for collection of lymphoma-free hematopoietic stems cells.

中文翻译：

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使用抗 CD20 Abs 从干细胞产品中体外和体内清除 B 淋巴瘤细胞

背景自体干细胞移植已被证明是复发性NHL的治愈性疗法。然而，在这种情况下，基础疾病的复发仍然是治疗失败的主要原因。方法 针对 B 细胞表面抗原 CD20 的有效 MAb 疗法的开发增加了一种有价值的工具，可以通过体外或体内应用从干细胞产品中清除污染的淋巴瘤细胞。结果 在大型 II 期研究中，使用 Mab 成功移植体外清除的骨髓与延长生存期相关。到目前为止，还没有随机试验可以证明体外清除的治疗益处。抗 CD20 Mab 利妥昔单抗已用于干细胞收集或移植周围的体内清除。该方法已被证明是安全可行的。在大多数患者中，利妥昔单抗与抗淋巴瘤化疗的组合意味着收集的干细胞产品不含分子可检测的淋巴瘤细胞。讨论 通过包括清髓疗法在内的方案在体内杀死所有淋巴瘤细胞的能力不断增强，这使得自体干细胞产品的污染性淋巴瘤细胞成为疾病复发的主要来源。清除这些细胞仍然是治愈性干细胞移植的先决条件。使用单克隆抗体建立安全有效的治疗方案将增加收集无淋巴瘤造血干细胞的机会。讨论 通过包括清髓疗法在内的方案在体内杀死所有淋巴瘤细胞的能力不断增强，这使得自体干细胞产品的污染性淋巴瘤细胞成为疾病复发的主要来源。清除这些细胞仍然是治愈性干细胞移植的先决条件。使用单克隆抗体建立安全有效的治疗方案将增加收集无淋巴瘤造血干细胞的机会。讨论 通过包括清髓疗法在内的方案在体内杀死所有淋巴瘤细胞的能力不断增强，这使得自体干细胞产品的污染性淋巴瘤细胞成为疾病复发的主要来源。清除这些细胞仍然是治愈性干细胞移植的先决条件。使用单克隆抗体建立安全有效的治疗方案将增加收集无淋巴瘤造血干细胞的机会。