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Radioimmunoconjugates in acute leukemia treatment: the future is radiant

Bone Marrow Transplantation volume 36, pages 1021–1026 (2005)Cite this article

Summary:

Targeted radiotherapy of the bone marrow using radiolabeled monoclonal antibodies is a therapeutic approach of considerable potential for the treatment of acute leukemia in addition to or as a substitute for total body irradiation. The data currently available, of about 300 patients, suggest that radioimmunotherapy (RIT) with β-emitters in acute leukemia is feasible and safe using a variety of antibodies (anti-CD33, anti-CD45, anti-CD66) and radionuclides (131I, 90Y, 188Re). It appears to reduce the risk of relapse in high-risk acute myelogenous leukemia (AML) patients transplanted early in the course of their disease (<15% blasts) to 20–30%. Furthermore, it has shown the potential to safely intensify reduced-intensity conditioning regimens (nonrelapse mortality of 25% compared to relapse rate of 55% within 2 years). Significant improvements in the results of refractory patients will probably depend on the successful further development of RIT with α-emitters or the use of a cocktail of antibodies labeled with α- and β-emitters, in a first dose escalation study of 213Bi-labeled anti-CD33 in refractory AML (partial) remission could be achieved in 5/18 patients. Randomized trials to evaluate the therapeutic efficacy of RIT in the context of stem cell transplantation have been initiated and the results are keenly anticipated.

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Acknowledgements

This work was supported by the German José Carreras Leukemia Foundation.

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Authors and Affiliations

  1. Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

    J Kotzerke

  2. Medizinische Klinik III, Universitätsklinikum Ulm, Ulm, Germany

    D Bunjes

  3. Molecular Pharmacology and Chemistry Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    D A Scheinberg

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  1. J Kotzerke
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  2. D Bunjes
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  3. D A Scheinberg
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Correspondence to J Kotzerke.

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Kotzerke, J., Bunjes, D. & Scheinberg, D. Radioimmunoconjugates in acute leukemia treatment: the future is radiant. Bone Marrow Transplant 36, 1021–1026 (2005). https://doi.org/10.1038/sj.bmt.1705182

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