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Blood, 1 August 2001, Vol. 98, No. 3, pp. 565-572
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Rhenium 188-labeled anti-CD66 (a, b, c, e) monoclonal antibody
to intensify the conditioning regimen prior to stem cell
transplantation for patients with high-risk acute myeloid leukemia or
myelodysplastic syndrome: results of a phase I-II study
Donald Bunjes,
Inga Buchmann,
Christian Duncker,
Ulrike Seitz,
Jörg Kotzerke,
Markus Wiesneth,
Dagmar Dohr,
Martin Stefanic,
Andreas Buck,
Stefanie V. Harsdorf,
Gerhard Glatting,
Wolfgang Grimminger,
Tunca Karakas,
Gerd Munzert,
Hartmut Döhner,
Lothar Bergmann, and
Sven N. Reske
From Departments of Haematology/Oncology, Nuclear
Medicine, Transfusion Medicine, and Radiotherapy, Ulm University
Hospital, Germany.
The conditioning regimen prior to stem cell transplantation in 36 patients with high-risk acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) was intensified by treating patients with a rhenium 188-labeled anti-CD66 monoclonal antibody. Dosimetry was performed prior to therapy, and a favorable dosimetry was observed
in all cases. Radioimmunotherapy with the labeled antibody provided a
mean of 15.3 Gy of additional radiation to the marrow; the kidney was
the normal organ receiving the highest dose of supplemental radiation
(mean 7.4 Gy). Radioimmunotherapy was followed by standard full-dose
conditioning with total body irradiation (12 Gy) or busulfan and
high-dose cyclophosphamide with or without thiotepa. Patients
subsequently received a T-cell-depleted allogeneic graft from a
HLA-identical family donor (n = 15) or an alternative donor
(n = 17). In 4 patients without an allogeneic donor, an unmanipulated
autologous graft was used. Infusion-related toxicity due to the labeled
antibody was minimal, and no increase in treatment-related mortality
due to the radioimmunoconjugate was observed. Day +30 and day +100
mortalities were 3% and 6%, respectively, and after a median
follow-up of 18 months treatment-related mortality was 22%. Late renal
toxicity was observed in 17% of patients. The relapse rate of 15 patients undergoing transplantation in first CR (complete remission) or
second CR was 20%; 21 patients not in remission at the time of
transplantation had a 30% relapse rate.
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Blood 2002 99: 2270-2271.
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