title: Initial Experience with Tositumomab and I-131-Labeled Tositumomab for Treatment of Relapsed/Refractory Hodgkin Lymphoma.
abstract: To determine the maximum tolerated dose (MTD) of [131I]tositumomab in patients with refractory/recurrent Hodgkin lymphoma (HL) and to preliminarily determine if [131I]tositumomab has activity against HL and if positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose ([18F]DG) performed 6 weeks post-therapy predicted 12-week response.
  
  
  
  Separate dose-finding studies were performed for patients with and without prior transplant. A single therapeutic total body radiation dose (TBD) of [131I]tositumomab was administered. TBD was escalated/de-escalated based on dose-limiting hematologic toxicity (DLT) using a modified continual reassessment method. [18F]DG-PET/CT scans were performed at baseline and 6 and 12 weeks post therapy.
  
  
  
  Twelve patients (nine classical HL, three lymphocyte-predominant [LP] HL) completed two dosing levels (n = 3 each) in the post-transplant (55 cGy, 79 cGy) and no transplant (75 cGy, 87 cGy) groups. Hematologic toxicities were common and transient. Twelve weeks after [131I]tositumomab, 10 patients progressed and two with LPHL achieved complete response. [18F]DG-PET/CT at 6 weeks post therapy appeared more predictive than CT at 6 weeks of a response at 12 weeks.
  
  
  
  Tositumomab and [131I]tositumomab was well-tolerated in patients with relapsed/refractory HL. Complete responses in LPHL support a therapeutic effect in this subtype. Early metabolic response assessments by [18F]DG-PET in HL after radioimmunotherapy appear to be more predictive than purely anatomic assessments.
authors: Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA. hjacene@partners.org.|Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Avenue, DL203, Boston, MA, 02215, USA. hjacene@partners.org.
authors: Heather
authors: 0000-0001-7167-078X
authors: H
authors: Jacene
authors: Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.|Mallinkrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
authors: John
authors: J
authors: Crandall
authors: Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.
authors: Yvette L
authors: YL
authors: Kasamon
authors: Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.
authors: Richard F
authors: RF
authors: Ambinder
authors: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai, Los Angeles, CA, USA.
authors: Steven
authors: S
authors: Piantadosi
authors: Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.
authors: Donna
authors: D
authors: Serena
authors: Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.
authors: Wayne
authors: W
authors: Kasecamp
authors: Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.|Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.|Mallinkrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
authors: Richard L
authors: RL
authors: Wahl
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D016896:Treatment Outcome; D014916:Whole-Body Irradiation; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; C119496:tositumomab I-131
keywords: Bexxar; FDG; Hodgkin; Hodgkin lymphoma; [131I]tositumomab