188Re or 90Y-labelled anti-CD66 antibody as part of a dose-reduced conditioning regimen for patients with acute leukaemia or myelodysplastic syndrome over the age of 55: results of a phase I-II study.
In a phase I-II study for patients aged 55-65 years, we employed radioimmunotherapy using an anti-CD-66 antibody as part of a dose-reduced conditioning regimen, which was followed by a T-cell-depleted graft. 20 patients with a median age of 63 years suffering from acute leukaemia (n=17) or myelodysplastic syndrome (n=3) received the antibody labelled either with 188Rhenium (n=8) or with 90Yttrium (n=12) during conditioning. Radioimmunotherapy provided a mean dose of 21.9 (+/-8.4) Gy to the bone marrow with a significantly higher dose when 90Yttrium was used. Additional conditioning was fludarabine-based plus anti-thymocyte globulin in matched related donor transplants (n=11), or plus melphalan in matched unrelated donor transplants (n=9). Regimen-related toxicity was low, with two patients developing three episodes of grade III organ toxicity. All patients engrafted, grade II-IV acute graft-versus-host disease (GvHD) was observed in one patient (5%) and chronic GvHD in three patients (15%). The cumulative incidence of non-relapse mortality was 25%, the cumulative incidence of relapse 55%. The probability of survival was estimated to be 70% at 1 year and 52% at 2 years post-transplant, although no plateau was reached afterwards. In conclusion, radioimmunotherapy using the anti-CD66 antibody was feasible and safe in our elderly patient group and provided a high marrow dose.
Ringhoffer
Mark
M
Department of Internal Medicine III, University of Ulm, Ulm, Germany.
Blumstein
Norbert
N
Neumaier
Bernd
B
Glatting
Gerhard
G
von Harsdorf
Stephanie
S
Buchmann
Inga
I
Wiesneth
Markus
M
Kotzerke
Jörg
J
Zenz
Thorsten
T
Buck
Andreas K
AK
Schauwecker
Peter
P
Stilgenbauer
Stephan
S
Döhner
Hartmut
H
Reske
Sven N
SN
Bunjes
Donald
D
D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015703:Antigens, CD / Q000276:immunology*; D000943:Antigens, Differentiation / Q000276:immunology*; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015815:Cell Adhesion Molecules; D005260:Female; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007938:Leukemia / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D008212:Lymphocyte Depletion; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D016499:Radioimmunotherapy / Q000379:methods*; D011868:Radioisotopes / Q000627:therapeutic use*; D011874:Radiometry; D012211:Rhenium / Q000627:therapeutic use; D033581:Stem Cell Transplantation; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D000943:Antigens, Differentiation; D000961:Antilymphocyte Serum; D000970:Antineoplastic Agents; C069847:CD66 antigens; D015815:Cell Adhesion Molecules; D007166:Immunosuppressive Agents; D011868:Radioisotopes; D015021:Yttrium Radioisotopes; D012211:Rhenium; D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan