title: The role of radioimmunotherapy in bone marrow transplantation.
abstract: Radioimmunotherapy offers an exciting new therapeutic modality for patients with recurrent hematologic malignancies and solid tumors resistant to conventional chemotherapy. In this review, a brief overview of tumor radiobiology as well as various obstacles to treatment is presented. Early radiolabeled antibody trials documented myelosuppression as the dose-limiting toxicity. Ongoing trials in solid tumors and hematologic malignancies are testing the hypothesis that myeloablative doses of radiation in conjunction with hematopoietic stem cell rescue will improve long-term survival. For solid tumors, there are many barriers to achieving this goal. The most encouraging trials in metastatic breast cancer have documented significant symptomatic relief and a 50% partial response in patients. In contrast, trials involving hematologic malignancies have produced more impressive results. With a median follow-up of 33 months, 67% of patients with recurrent acute myelogenous leukemia or myelodysplasia treated with radiolabeled antibodies, total-body irradiation, and high-dose chemotherapy remain disease free. Alone, myeloablative doses of radioimmunotherapy have documented a 41% complete response in patients with Hodgkin's disease. Seattle trials with recurrent non-Hodgkin's lymphoma have demonstrated objective responses in 90% of patients, complete responses in 85% of patients, a progression-free survival of 62%, and an overall survival of 93% with a median follow-up of 2 years.
authors.affiliation: Division of Medical Oncology, University of Washington Medical Center, Seattle 98195-6043, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Corcoran
authors.forename: O W
authors.initials: OW
authors.lastname: Press
authors.forename: D C
authors.initials: DC
authors.lastname: Matthews
authors.forename: F R
authors.initials: FR
authors.lastname: Appelbaum
authors.forename: I D
authors.initials: ID
authors.lastname: Bernstein
mesh_terms: D016026:Bone Marrow Transplantation; D002986:Clinical Trials as Topic; D005260:Female; D019337:Hematologic Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D016499:Radioimmunotherapy