| Abstract: |
Targeted radiotherapy of the bone marrow using radiolabeled monoclonal antibodies is a therapeutic approach of considerable potential for the treatment of acute leukemia in addition to or as a substitute for total body irradiation. The data currently available, of about 300 patients, suggest that radioimmunotherapy (RIT) with β-emitters in acute leukemia is feasible and safe using a variety of antibodies (anti-CD33, anti-CD45, anti-CD66) and radionuclides (131I, 90Y, 188Re). It appears to reduce the risk of relapse in high-risk acute myelogenous leukemia (AML) patients transplanted early in the course of their disease (<15% blasts) to 20-30%. Furthermore, it has shown the potential to safely intensify reduced-intensity conditioning regimens (nonrelapse mortality of 25% compared to relapse rate of 55% within 2 years). Significant improvements in the results of refractory patients will probably depend on the successful further development of RIT with α-emitters or the use of a cocktail of antibodies labeled with α- and β-emitters, in a first dose escalation study of 213Bi-labeled anti-CD33 in refractory AML (partial) remission could be achieved in 5/18 patients. Randomized trials to evaluate the therapeutic efficacy of RIT in the context of stem cell transplantation have been initiated and the results are keenly anticipated. © 2005 Nature Publishing Group. All rights reserved. |
| Keywords: |
treatment outcome; leukemia; unclassified drug; acute granulocytic leukemia; busulfan; fludarabine; clinical trial; review; nonhuman; cancer patient; radiation dose; methotrexate; quality control; cyclophosphamide; melphalan; stem cell transplantation; cancer mortality; high risk patient; dose-response relationship, radiation; monoclonal antibody; antibodies, monoclonal; whole body radiation; feasibility study; clinical study; iodine 131; drug distribution; isotope labeling; dosimetry; graft versus host reaction; cell adhesion molecules; radiometry; antigens, cd; drug half life; radioimmunotherapy; cyclosporin a; leukemia relapse; risk reduction; mycophenolic acid 2 morpholinoethyl ester; drug dose regimen; radioisotopes; yttrium radioisotopes; clinical trials; alemtuzumab; leukemia remission; antigens, differentiation, myelomonocytic; radiobiology; beta rays; antigens, cd45; immunoconjugates; conditioning; alpha particles; actinium; yttrium 90; astatine 211; bismuth 213; rhenium; rhenium 188; radioimmunoconjugates; monoclonal antibody cd33; monoclonal antibody cd45; monoclonal antibody cd66
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