Myeloablative Radioimmunotherapy in Conditioning of Acute Leukemia, MDS, and Multiple Myeloma Prior to Hematological Stem Cell Transplantation

Part of the Medical Radiology book series (MEDRAD)


High dose radio-/chemotherapy in the context of autologous and allogeneic hematopoietic stem cell transplantation is a double-edged sword. The requirement for dose intensification is linked to an increase in toxicity to noninvolved organs. Particularly for older and co-morbid patients, efficient but toxicity-reduced schemes are needed. Myeloablative radioimmunotherapy is a targeted, internal radiotherapy that uses radio-labeled monoclonal antibodies (mAb) with affinity to the bone marrow. It applies high radiation doses up to 30 Gy into the bone marrow and spleen, but omits radio-sensitive organs to doses higher than 1–7 Gy. Added to conventional or intensity-reduced conditioning, myeloablative radioimmunotherapy may achieve a pronounced antileukemic effect with tolerable toxicities. A rational and individual design of the ideal nuclide-antibody combination optimizes therapy. The anti-CD33-, -CD45-, and -CD66-mAb appear to be ideal tracers so far. The [beta]Yttrium-90 is coupled by DTPA and is the most qualified nuclide for myeloablation. Approval trials for DTPA-anti-CD66-mAb are on the way in Europe and these therapies may become practically applicable in perspective.


Multiple Myeloma Acute Myeloid Leukemia Stem Cell Transplantation Chronic Myeloid Leukemia Autologous Stem Cell Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Head of the Department of Nuclear MedicineUniversity Hospital Schleswig–HolsteinLübeckGermany

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