Yttrium 90-labeled antiferritin followed by high-dose chemotherapy and autologous bone marrow transplantation for poor-prognosis Hodgkin's disease.
OBJECTIVE
This study was undertaken to examine the feasibility of combining radiolabeled antibody therapy with high-dose chemotherapy followed by autologous bone marrow transplantation in patients with poor-prognosis Hodgkin's disease.


METHODS
Patients were entered onto this protocol if they had chemotherapy-resistant disease, bulky disease, or extensive prior therapy. Patients received yttrium-labeled antiferritin on day -13, -12, or -11, followed by high-dose cyclophosphamide, carmustine, and etoposide (CBV) on days -6 to -3, and then bone marrow infusion on day 0.


RESULTS
Twelve patients received both radiolabeled antibody and high-dose chemotherapy followed by autologous transplantation. Two additional patients started the study, but were unable to complete all therapy. Four of 12 patients experienced early transplant-related mortality. Four patients are alive more than 2 years following transplantation and three are free from disease progression at 24+, 25+, and 28+ months following transplantation. The progression-free survival rate at 1 year is estimated to be 21%. Considering the poor prognostic characteristics of these patients, toxicity on this protocol was not necessarily greater than that observed with high-dose chemotherapy alone.


CONCLUSIONS
This report demonstrates the feasibility of combining radiolabeled antibody therapy with high-dose chemotherapy and autologous bone marrow transplantation.
Bierman
P J
PJ
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
Vose
J M
JM
Leichner
P K
PK
Quadri
S M
SM
Armitage
J O
JO
Klein
J L
JL
Abrams
R A
RA
Dicke
K A
KA
Vriesendorp
H M
HM
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002330:Carmustine / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005293:Ferritins / Q000276:immunology; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D009363:Neoplasm Proteins / Q000276:immunology; D011379:Prognosis; D016499:Radioimmunotherapy; D015996:Survival Rate; D015021:Yttrium Radioisotopes
D009363:Neoplasm Proteins; D015021:Yttrium Radioisotopes; D005047:Etoposide; D003520:Cyclophosphamide; D005293:Ferritins; D002330:Carmustine