|
|
Prepublished online as a Blood First Edition Paper on May 1, 2003; DOI 10.1182/blood-2002-10-3250.
 Previous Article | Table of Contents | Next Article 
Blood, 1 October 2003, Vol. 102, No. 7, pp. 2684-2691
TRANSPLANTATION
166Ho-DOTMP plus melphalan followed by peripheral blood stem cell transplantation in patients with multiple myeloma: results of two phase 1/2 trials
Sergio Giralt,
William Bensinger,
Mark Goodman,
Donald Podoloff,
Janet Eary,
Richard Wendt,
Raymond Alexanian,
Donna Weber,
David Maloney,
Leona Holmberg,
Joseph Rajandran,
Hazel Breitz,
Richard Ghalie, and
Richard Champlin
From the MD Anderson Cancer Center, Houston, TX; the Fred Hutchinson Cancer Research Center; the University of Miami Medical Center, Miami, FL; the University of Washington Medical Center; and NeoRx, Seattle, WA.
Holmium-166 1, 4, 7, 10-tetraazcyclododecane-1, 4, 7, 10-tetramethylenephosphonate (166Ho-DOTMP) is a radiotherapeutic that localizes specifically to the skeleton and can deliver high-dose radiation to the bone and bone marrow. In patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation two phase 1/2 dose-escalation studies of high-dose 166Ho-DOTMP plus melphalan were conducted. Patients received a 30 mCi (1.110 Gbq) tracer dose of 166Ho-DOTMP to assess skeletal uptake and to calculate a patient-specific therapeutic dose to deliver a nominal radiation dose of 20, 30, or 40 Gy to the bone marrow. A total of 83 patients received a therapeutic dose of 166Ho-DOTMP followed by autologous hematopoietic stem cell transplantation 6 to 10 days later. Of the patients, 81 had rapid and sustained hematologic recovery, and 2 died from infection before day 60. No grades 3 to 4 nonhematologic toxicities were reported within the first 60 days. There were 27 patients who experienced grades 2 to 3 hemorrhagic cystitis, only 1 of whom had received continuous bladder irrigation. There were 7 patients who experienced complications considered to be caused by severe thrombotic microangiopathy (TMA). No cases of severe TMA were reported in patients receiving in 166Ho-DOMTP doses lower than 30 Gy. Approximately 30% of patients experienced grades 2 to 4 renal toxicity, usually at doses targeting more than 40 Gy to the bone marrow. Complete remission was achieved in 29 (35%) of evaluable patients. With a minimum follow-up of 23 months, the median survival had not been reached and the median event-free survival was 22 months. 166Ho-DOTMP is a promising therapy for patients with multiple myeloma and merits further evaluation. (Blood. 2003;102:2684-2691)
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
A. Chang, S. Hingorani, J. Kowalewska, M. E.D. Flowers, T. Aneja, K. D. Smith, S. M. Meehan, R. F. Nicosia, and C. E. Alpers
Spectrum of Renal Pathology in Hematopoietic Cell Transplantation: A Series of 20 Patients and Review of the Literature
Clin. J. Am. Soc. Nephrol.,
September 1, 2007;
2(5):
1014 - 1023.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. S. Yeh and J. R. Berenson
Treatment for myeloma bone disease.
Clin. Cancer Res.,
October 15, 2006;
12(20):
6279s - 6284s.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Goel, A. Dispenzieri, S. M. Geyer, S. Greiner, K.-W. Peng, and S. J. Russell
Synergistic activity of the proteasome inhibitor PS-341 with non-myeloablative 153-Sm-EDTMP skeletally targeted radiotherapy in an orthotopic model of multiple myeloma
Blood,
May 15, 2006;
107(10):
4063 - 4070.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. B. Breitz, R. E. Wendt III, M. S. Stabin, S. Shen, W. D. Erwin, J. G. Rajendran, J. F. Eary, L. Durack, E. Delpassand, W. Martin, et al.
166Ho-DOTMP Radiation-Absorbed Dose Estimation for Skeletal Targeted Radiotherapy
J. Nucl. Med.,
March 1, 2006;
47(3):
534 - 542.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J E Moulder and E P Cohen
Radiation-induced multi-organ involvement and failure: the contribution of radiation effects on the renal system
Br. J. Radiol.,
January 1, 2005;
Supplement_27(1):
82 - 88.
[Abstract]
[Full Text]
[PDF]
|
|
|
| |
