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Prepublished online as a Blood First Edition Paper on May 1, 2003; DOI 10.1182/blood-2002-10-3250. This Article Full Text (PDF) All Versions of this Article: 2002-10-3250v1 102/7/2684    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Giralt, S. Articles by Champlin, R. Search for Related Content PubMed PubMed Citation Articles by Giralt, S. Articles by Champlin, R. Social Bookmarking                   What's this? Submitted November 4, 2002 Accepted March 2, 2003 166Ho-DOTMP plus melphalan followed by peripheral blood stem cell transplantation in patients with multiple myeloma: results of two phase I/II 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 Department of Blood and Marrow Transplantation, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA Fred Hutchinson Cancer Research Center, Seattle, WA, USA University of Miami Medical Center, Miami, FL, USA Neo Rx Corporation, Seattle, WA, USA * Corresponding author; email: sgiralt{at}mdanderson.org. 166Ho-DOTMP is a radiotherapeutic that localizes specifically to the skeleton and can deliver high dose radiation to the bone and bone marrow. Two Phase I/II dose escalation studies of high dose 166Ho-DOTMP plus melphalan were conducted in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplant. Patients received a 30 mCi 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. Eighty-three patients received a therapeutic dose of 166Ho-DOTMP followed by autologous hematopoietic stem cell transplant 6 to 10 days later. Eighty-one patients had rapid and sustained hematologic recovery, and 2 patients died from infection before Day 60. No Grade 3-4 non-hematologic toxicities were reported within the first 60 days. Twenty-seven patients experienced Grade 2-3 hemorrhagic cystitis, only one of whom had received continuous bladder irrigation. Seven patients experienced complications considered to be caused by severe thrombotic microangiopathy (TMA). No cases of severe TMA were reported in patients receiving 166Ho-DOMTP doses less than 30 Gy. Approximately 30% of patients experienced Grade 2 to 4 renal toxicity, usually at doses targeting over 40 Gy to the bone marrow. Twenty-nine of patients (35%) achieved a complete response. 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 as part of a preparative regimen for hematopoietic stem cell transplantation is a promising therapy for patients with multiple myeloma and merits further evaluation. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: B. W. Wessels, M. W. Konijnenberg, R. G. Dale, H. B. Breitz, M. Cremonesi, R. F. Meredith, A. J. Green, L. G. Bouchet, A. B. Brill, W. E. Bolch, et al. MIRD Pamphlet No. 20: The Effect of Model Assumptions on Kidney Dosimetry and Response--Implications for Radionuclide Therapy J. Nucl. Med., November 1, 2008; 49(11): 1884 - 1899. [Abstract] [Full Text] [PDF] 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] G. Sgouros Dosimetry of Internal Emitters J. Nucl. Med., January 1, 2005; 46(1_suppl): 18S - 27S. [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]

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