Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2001-8-15
pubmed:abstractText
Disease recurrence following stem cell transplantation (SCT) remains a major problem. Despite the sensitivity of leukaemias to chemotherapy and irradiation, conventional conditioning before SCT is limited by significant organ toxicity. Targeted irradiation of bone marrow and spleen by radioimmunotherapy may provide considerable dose escalation, with limited toxicity to non-target organs. In this study, 27 patients with high-risk or relapsing leukaemia were treated with rhenium-188-labelled CD66a,b,c,e radioimmunoconjugates (188Re-mAb) specific for normal bone marrow in addition to conventional conditioning with high-dose chemotherapy and 12 Gy total body irradiation prior to SCT. A mean activity of 10.2+/-2.1 (range 6.9-15.8) GBq 188Re-mAb was administered intravenously. Acute side-effects were assessed according to the CTC classification and patient outcome was determined. Mean radiation doses (Gy; range in parentheses) to relevant organs and whole body were as follows: 13.1 (6.5-22) to bone marrow, 11.6 (1.7-31.1) to spleen, 5.0 (2.0-11.7) to liver, 7.0 (2.3-11.6) to kidneys, 0.7 (0.3-1.3) to lungs and 1.4 (0.8-2.1) to the whole body. Stem cells engrafted in all patients within 9-18 days post SCT. Acute organ toxicity of grade II or less was observed. During follow-up for 25.4+/-5.3 (range 18-34) months, 4/27 (15%) patients died from relapse, and 9/27 (33%) from transplantation-related complications. Fourteen patients (52%) are still alive and in ongoing complete clinical remission. Radioimmunotherapy with the bone marrow-seeking 188Re-labelled CD66 mAb can double the dose to bone marrow and spleen without undue extramedullary acute organ toxicity, when given in addition to high-dose chemotherapy and 12 Gy TBI before allogeneic SCT. This intensified conditioning regimen may reduce the relapse rate of high-risk leukaemia.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
0340-6997
pubmed:author
pubmed:issnType
Print
pubmed:volume
28
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
807-15
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:11504076-Adolescent, pubmed-meshheading:11504076-Adult, pubmed-meshheading:11504076-Antibodies, Monoclonal, pubmed-meshheading:11504076-Antigens, CD, pubmed-meshheading:11504076-Bone Marrow, pubmed-meshheading:11504076-Disease-Free Survival, pubmed-meshheading:11504076-Female, pubmed-meshheading:11504076-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:11504076-Humans, pubmed-meshheading:11504076-Leukemia, pubmed-meshheading:11504076-Male, pubmed-meshheading:11504076-Middle Aged, pubmed-meshheading:11504076-Radiation Dosage, pubmed-meshheading:11504076-Radioimmunotherapy, pubmed-meshheading:11504076-Radioisotopes, pubmed-meshheading:11504076-Recurrence, pubmed-meshheading:11504076-Rhenium, pubmed-meshheading:11504076-Survival Rate, pubmed-meshheading:11504076-Transplantation Conditioning, pubmed-meshheading:11504076-Whole-Body Irradiation
pubmed:year
2001
pubmed:articleTitle
Targeted bone marrow irradiation in the conditioning of high-risk leukaemia prior to stem cell transplantation.
pubmed:affiliation
Abteilung Nuklearmedizin, Universitätsklinikum Ulm, Germany. sven.reske@medizin.uni-ulm.de
pubmed:publicationType
Journal Article, Clinical Trial, Research Support, Non-U.S. Gov't, Clinical Trial, Phase II, Clinical Trial, Phase I