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Radioimmunotherapy of interleukin-2R alpha-expressing adult T-cell leukemia
with Yttrium-90-labeled anti-Tac [see comments]
TA Waldmann, JD White, JA Carrasquillo, JC Reynolds, CH Paik, OA Gansow, MW Brechbiel, ES Jaffe, TA Fleisher and CK Goldman
Metabolism Branch, National Cancer Institute, National Institutes of
Health, Bethesda, MD 20892, USA.
Adult T-cell leukemia (ATL) is a malignancy of mature lymphocytes caused by
the retrovirus human T-cell lymphotropic virus-I. It is an aggressive
leukemia with a median survival time of 9 months; no chemotherapy regimen
appears successful in inducing long-term disease- free survival. The
scientific basis of the present study is that ATL cells express
high-affinity interleukin-2 receptors identified by the anti-Tac monoclonal
antibody, whereas normal resting cells do not. To exploit this difference,
we administered anti-Tac armed with Yttrium-90 (90Y) to 18 patients with
ATL initially (first 9 patients) in a phase I dose-escalation trial and
subsequently (second group of 9 patients) in a phase II trial involving a
uniform 10-mCi dose of 90Y-labeled anti- Tac. Patients undergoing a
remission were permitted to receive up to eight additional doses. At the 5-
to 15-mCi doses used, 9 of 16 evaluable patients responded to 90Y anti-Tac
with a partial (7 patients) or complete (2 patients) remission. The
responses observed represent improved efficacy in terms of length of
remission when compared with previous results with unmodified anti-Tac.
Clinically meaningful (> or = grade 3) toxicity was largely limited to
the hematopoietic system. In conclusion, radioimmunotherapy with 90Y anti-
Tac directed toward the IL-2R expressed on ATL cells may provide a useful
approach for treatment of this aggressive malignancy.
Volume 86,
Issue 11,
pp. 4063-4075,
12/01/1995
Copyright © 1995 by The American Society of Hematology

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