Science Highlights
Published on February 29, 2024
131I-anti-CD45 radioimmunotherapy prior to HCT in high-risk leukemia and MDS
by AACR
Orozco JJ, Vo PT, Gooley TA, et al. Targeted Radiation Delivery Before Haploidentical HCT for High-Risk Leukemia or MDS Patients Yields Long-Term Survivors. Clinical Cancer Research. 2024; 30 (2): 274 (doi: 10.1158/1078-0432.CCR-23-1200).
Targeted radiation delivery is a viable option for cancer patients whose intolerance of high-dose chemotherapy is a barrier to potentially curative hematopoietic cell transplantation (HCT), researchers report. The sample population for the Phase I/II study included adults with high-risk relapsed/refractory disease: 20 with acute myeloid leukemia (AML), 4 with acute lymphoid leukemia (ALL), and 1 with myelodysplastic syndrome (MDS). Instead of myeloablative conditioning prior to HLA-haploidentical HCT, each patient received radioimmunotherapy with iodine-131 (131I)-anti-CD45 antibody BC8 — first as a tracer diagnostic dose and then as a therapeutic infusion. This pretreatment was followed by nonmyeloablative conditioning, in the form of chemotherapy with fludarabine and cyclophosphamide plus 2 Gy of total-body irradiation. By day 28 post-transplant, all patients achieved morphologic remission. Overall survival and progression-free survival at 1 year were measured at 40% and 32%, respectively, with both dropping to 24% at 2 years. One-year relapse and nonrelapse mortality estimates were 56% and 12%, respectively. The findings indicate 131I-anti-CD45 radioimmunotherapy before haploidentical HCT may be curative in some recipients without added toxicity, study authors conclude.
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