Recurrence of Hodgkin's disease after indium-111 and yttrium-90 labeled antiferritin administration.
BACKGROUND
Indium-111 labeled antiferritin targets 95% of all Hodgkin's disease lesions with a diameter of 1 cm or more. Subsequent treatment with yttrium-90 labeled antiferritin secures a high response rate in patients with recurrent Hodgkin's disease.


METHODS
A total of 87 patients were entered on one of three different yttrium-90 labeled antiferritin protocols. Recurrences after yttrium-90 treatment were analyzed. Nine patients were retreated with involved external beam radiation fields, selected with the help of indium-111 labeled antiferritin.


RESULTS
In single-agent yttrium-90 antiferritin studies, a response rate of more than 60% was found, with an average response duration of 6 months. One-third of the patients had recurrences in previously uninvolved areas. Repeat indium antiferritin scintigraphy allowed for the selection of new radiation fields for recurrences. In-field disease control was obtained for a median of 8 months, but new recurrences in new areas occurred. Chemotherapy or radiation therapy given immediately before antiferritin decreased tumor targeting with indium-111 labeled antiferritin.


CONCLUSIONS
Recurrences after radiolabeled antiferritin treatment are not due to radioresistant Hodgkin's disease. In contrast, Hodgkin's disease less than 1 cm in diameter is not targeted and not controlled by radiolabeled antiferritin. New multimodality regimens with a higher therapeutic ratio are needed for treatment of Hodgkin's disease with curative intent. Radiolabeled antiferritin can be incorporated in such regimens to secure better control of bulky Hodgkin's disease (>1 cm in diameter), but it should be given before chemotherapy or radiation therapy.
Vriesendorp
H M
HM
University of Texas, M. D. Anderson Cancer Center, Houston, USA.
Quadri
S M
SM
Andersson
B S
BS
Wyllie
C T
CT
Dicke
K A
KA
D005293:Ferritins / Q000276:immunology*; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D007205:Indium Radioisotopes / Q000627:therapeutic use*; D016499:Radioimmunotherapy; D012008:Recurrence; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D007205:Indium Radioisotopes; D015021:Yttrium Radioisotopes; D005293:Ferritins