Successful Treatment of Human Waldenström's Macroglobulinemia with Combination Biological and Chemotherapy Agents

The immunomodulating effects and antitumor activity of two biological agents, bryostatin 1 (Bryol) and α-interferon, were tested in vitro and in vivo either alone or prior to chemotherapy agents, against a Waldenstrom's macroglobulinemia tumor line (WSU-WM). Bryol caused a decrease in the expression of CD10, CD19, IgM, LeulO, and CD22 and a temporary growth inhibition as measured by cell cycle analysis. α-Interferon did not show any major effects. In vivo, severe combined immunodeficient mice were used to test the activity of the agents against WSU-WM. Bryol (i.p.) was given either alone or sequentially with doxorubicin (i.v.), vincristine (i.v.), melphalan (i.v.), and α-interferon (i.v.). Bryol given 24 h before vincristine or melphalan resulted in the highest tumor growth inhibition, tumor growth delay, and tumor cell kill. Two of five mice receiving Bryol/vincristine combination were free of tumors >200 days after treatment and were considered cured. In light of our findings, we recommend that Bryol be considered for clinical investigation in human B-cell tumors and might best be given combined with other chemotherapy agents used in the treatment of that disease. Whether Bryol is acting as a differentiating agent or as a direct anti-Waldenstrom's macroglobulinemia tumor agent, remains unclear.