[Radioimmunotherapy with yttrium-90 ibritumomab tiuxetan. Clinical considerations, radiopharmacy, radiation protection, perspectives].
90Y-ibritumomab tiuxetan (Zevalin) is currently approved for radioimmunotherapy of patients with relapsed or refractory follicular non-Hodgkin's lymphoma pretreated with rituximab. Future directions are the combined use of 90Y-ibritumomab tiuxetan as part of the initial treatment and as first-line multi-agent therapy of relapsed disease. Current studies investigate patients with other than follicular indolent histologies, e. g. diffuse large cell lymphoma. Labelling of 90Y ibritumomab tiuxetan is a safe procedure, the radiochemical purity is not disturbed by a higher room temperature or by metallic impurity. Quality control is recommended by thin layer chromatography (TLC), strips >15 cm are favourable. TLC cannot distinguish between the correctly radiolabelled antibodies and radiocolloid impurity. If necessary, additional HPLC should be performed. Radiocolloid impurities are absorbed to the solid phase and do not reach the eluate. If the radiochemical purity test is insufficient (<95%), the additional cleaning using EconoPac 10 DG columns (Biorad, Hercules, CA, USA) is a reliable procedure to reduce the percentage of free radionuclide. However, this procedure is not part of the approval.
Schomäcker
K
K
Klinik und Poliklinik für Nuklearmedizin, der Universität zu Köln, Kerpener Str. 62, 50924 Köln. klaus.schomaecker@uni-koeln.de
Dietlein
M
M
Schnell
R
R
Pinkert
J
J
Eschner
W
W
Zimmermanns
B
B
Fischer
T
T
Engert
A
A
Schicha
H
H
D000740:Anemia / Q000000981:diagnostic imaging; D000911:Antibodies, Monoclonal / Q000627:therapeutic use / Q000633:toxicity; D002851:Chromatography, High Pressure Liquid; D006801:Humans; D008223:Lymphoma / Q000532:radiotherapy; D009503:Neutropenia / Q000000981:diagnostic imaging; D011786:Quality Control; D011835:Radiation Protection; D016499:Radioimmunotherapy / Q000379:methods*; D011877:Radionuclide Imaging; D013921:Thrombocytopenia / Q000000981:diagnostic imaging; D015021:Yttrium Radioisotopes / Q000592:standards* / Q000627:therapeutic use / Q000633:toxicity
D000911:Antibodies, Monoclonal; D015021:Yttrium Radioisotopes; C422802:ibritumomab tiuxetan