Myeloma immunoglobulin idiotype (Id) (Id)

The myeloma immunoglobulin idiotype is the unique antigenic determinant found in the variable regions of the monoclonal immunoglobulin (M-protein) secreted by malignant plasma cells (PubMed: 11511150). Because this idiotype results from unique genetic rearrangements during B-cell development, it functions as a neoantigen or tumor-specific antigen (TSA) unique to each patient (NIH: PMC2726112). In Multiple Myeloma, the idiotype is a primary target for personalized active immunotherapy, such as idiotype-pulsed dendritic cell vaccines or idiotype-KLH conjugate vaccines (PubMed: 10600680). These therapies aim to induce a robust T-cell and B-cell mediated immune response specifically against the cancerous clone while sparing healthy cells. However, the clinical utility is often limited by the requirement for custom manufacturing for every patient and the immunosuppressive environment of advanced myeloma (PubMed: 15140445). Recent research also explores the use of idiotype-specific CAR-T cells and bispecific antibodies to improve efficacy (PubMed: 30655270).

Other names

Tumor-specific idiotypeM-protein idiotypeMonoclonal immunoglobulin idiotypePatient-specific idiotype antigen

Active immunization using patient-specific idiotype protein (often conjugated to KLH) or idiotype-pulsed dendritic cells to stimulate a polyclonal T-cell and B-cell response against the malignant plasma cell clone (PubMed: 10600680, PubMed: 11511150).