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Transplantation in Hematology and Oncology II pp 43–58Cite as

Intensification of the Conditioning Regimen for Patients with high-risk AML and MDS: 3 year Experience of using an188 Re — Labelled anti — CD 66 Monoclonal Antibody

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Abstract

We have intensified the conditioning regimen prior to stem cell transplantation in 42 patients with high-risk AML and MDS by treating patients with a 188 Re — labeled anti — CD 66 monoclonal antibody. Dosimetry was performed prior to therapy and a favourable dosimetry was observed in all cases. Radioimmunotherapy with the labeled antibody provided a mean of 15.3 Gy of additional radiation to the marrow, the kidney was the normal organ receiving the highest dose of supplemental radiation (mean 7.3 Gy): Radioimmunotherapy was followed by standard full-dose conditioning with total body irradiation (12 Gy) or busulfan and high — dose cyclophosphamide ± thiotepa. Patients subsequently received a T cell depleted allogeneic graft from a HLA — identical family donor (n = 16) or an alternative donor (n = 22). In 4 patients without an allogeneic donor an unmanipulated autologous graft was used. Infusion — related toxicity due to the labeled antibody was minimal and no increase in treatment — related mortality due to the radioimmunoconjugate was observed. Day +30 and day +100 mortalities were 2% and 5% respectively and after a median follow-up of 22 months treatment-related mortality was 24%. Late renal toxicity was observed in 14% of patients. The relapse rate of 19 patients transplanted in 1.CR or 2.CR was 16%, in 23 patients not in remission at the time of transplant we observed a 36% relapse rate.

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Authors and Affiliations

  1. Department of Haematology/Oncology, Germany

    D. Bunjes, Ch. Duncker, M. Stefanic, St. v. Harsdorf, W. Grimminger, R. Schlenk, G. Munzert, H. Döhner & L. Bergmann

  2. Department of Nuclear Medicine, Germany

    I. Buchmann, U. Seitz, J. Kotzerke, A. Buck, G. Glatting & S. N. Reske

  3. Department of Transfusion Medicine, Germany

    M. Wiesneth

  4. Department of Radiotherapy, Germany

    D. Dohr

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  1. D. Bunjes
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  2. I. Buchmann
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  3. Ch. Duncker
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  4. U. Seitz
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  8. M. Stefanic
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Editors and Affiliations

  1. Department of Internal Medicine Hematology/Oncology, University of Münster, Albert-Schweitzer-Straße 33, 48129, Münster, Germany

    W. E. Berdel Prof. Dr. med. , Th. Büchner Prof. Dr. med.  & J. Kienast Prof. Dr. med. ,  & 

  2. Department of Pediatrics Hematology/Oncology, University of Münster, Albert-Schweitzer-Straße 33, 48129, Münster, Germany

    H. Jürgens Prof. Dr. med. , J. Ritter Prof. Dr. med.  & J. Vormoor Dr. med. ,  & 

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Bunjes, D. et al. (2003). Intensification of the Conditioning Regimen for Patients with high-risk AML and MDS: 3 year Experience of using an188 Re — Labelled anti — CD 66 Monoclonal Antibody. In: Berdel, W.E., Büchner, T., Kienast, J., Jürgens, H., Ritter, J., Vormoor, J. (eds) Transplantation in Hematology and Oncology II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55774-3_6

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  • DOI: https://doi.org/10.1007/978-3-642-55774-3_6

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