Radioimmunotherapy with [188Re]-labelled anti-CD66 antibody in the conditioning for allogeneic stem cell transplantation for high-risk acute myeloid leukemia.
Between July 2000 and June 2003 a total of 21 patients with high-risk acute myeloid leukemia (AML; n = 14), AML after myelodysplastic syndrome (MDS; n = 6) or advanced MDS (n = 1) were treated with an 188-Re labelled anti-CD66 antibody in the conditioning regimen for allogeneic stem cell transplantation. Radioimmunotherapy (RIT) was followed by standard full-dose conditioning with busulfan and high-dose cyclophosphamide in 11 patients and reduced intensity conditioning regimen in 10 patients. All patients received an unmanipulated allogeneic graft from alternative donors (n = 15) or a HLA-identical familiy donor (n = 6). With a median follow up of 42 months (23-60) disease free survival for all patients was 43%. Nine patients are still alive and in ongoing complete hematological remission. The treatment related mortality was 28.6% (n = 6) and an equal number of patients died of relapsing disease within 30-385 days after transplantation. Late organ toxicity, monitored for more than 1 year, was mild and not clinically relevant. The combination of RIT with chemotherapeutic conditioning seems to be a therapy with an acceptable risk of treatment related morbidity and mortality as well as occurrence of severe acute GvHD.
Koenecke
Christian
C
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Hofmann
Michael
M
Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Bolte
Oliver
O
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Gielow
Peter
P
Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Dammann
Elke
E
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Stadler
Michael
M
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Franzke
Anke
A
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Boerner
Anne Rose
AR
Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Eder
Matthias
M
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Ganser
Arnold
A
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Knapp
Wolfram
W
Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Hertenstein
Bernd
B
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany. Hertenstein.Bernd@mh-hannover.de.|Klinikum-Bremen-Mitte, St.-Jürgen-Str. 1, Bremen, Germany. Hertenstein.Bernd@mh-hannover.de.
D000328:Adult; D000906:Antibodies / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D015703:Antigens, CD / Q000276:immunology*; D015815:Cell Adhesion Molecules / Q000276:immunology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000276:immunology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D016499:Radioimmunotherapy / Q000009:adverse effects; D011868:Radioisotopes; D012008:Recurrence; D012211:Rhenium; D012307:Risk Factors; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous
D000906:Antibodies; D015703:Antigens, CD; C069847:CD66 antigens; D015815:Cell Adhesion Molecules; D011868:Radioisotopes; D012211:Rhenium