Cited by 525Radiopharmaceutical Chemistry and ApplicationsLymphoma Diagnosis and TreatmentChronic Lymphocytic Leukemia Research

Radioimmunotherapy with iodine 131I tositumomab for relapsed or refractory B-cell non-Hodgkin lymphoma: updated results and long-term follow-up of the University of Michigan experience

Kaminski, Mark S., Estes, Judith, Zasadny, Kenneth R., Francis, Isaac R., Ross, Charles W., Tuck, Melissa, Regan, Denise, Fisher, Susan +5 more·2000·Blood

Abstract

CD20-targeted radioimmunotherapy is a promising new treatment for B-cell non-Hodgkin lymphoma (NHL). We now provide updated and long-term data on 59 chemotherapy-relapsed/refractory patients treated with iodine (131)I tositumomab in a phase I/II single-center study. Fifty-three patients received individualized therapeutic doses, delivering a specified total-body radiation dose (TBD) based on the clearance rate of a preceding dosimetric dose. Six patients received dosimetric doses only. Dose-escalations of TBD were conducted separately in patients who had or had not undergone a prior autologous stem cell transplant (ASCT) until a nonmyeloablative maximally tolerated TBD was established (non-ASCT = 75 cGy, post-ASCT = 45 cGy). Fourteen additional non-ASCT patients were treated with 75 cGy. Unlabeled antibody was given prior to labeled dosimetric and therapeutic doses to improve biodistribution. Forty-two (71%) of 59 patients responded; 20 (34%) had complete responses (CR). Thirty-five (83%) of 42 with low-grade or transformed NHL responded versus 7 (41%) of 17 with de novo intermediate-grade NHL (P =.005). For all 42 responders, the median progression-free survival was 12 months, 20.3 for those with CR. Seven patients remain in CR 3 to 5.7 years. Sixteen patients were re-treated after progression; 9 responded and 5 had a CR. Reversible hematologic toxicity was dose limiting. Only 10 patients (17%) had human anti-mouse antibodies detected. Long-term, 5 patients developed elevated thyroid-stimulating hormone levels, 5 were diagnosed with myelodysplasia and 3 with solid tumors. A single, well-tolerated treatment with iodine (131)I tositumomab can, therefore, produce frequent and durable responses in NHL, especially low-grade or transformed NHL. (Blood. 2000;96:1259-1266)

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Registry

Crossref · 10.1182/blood.v96.4.1259

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  • Whole-body absorbed dose has been used effectively as a surrogate for marrow dosimetry in patients receiving 131I-tositumomab, with an MTD of 75 cGy as a single administration in heavily pretreated patients without major marrow involvement with tumor.

    “and in patients receiving 131 I-tositumomab (MTD 5 75 cGy, single administration in heavily pretreated patients without major marrow involvement with tumor) ( 92 , 93 ).”

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Authors
Kaminski, M. S., Estes, J., Zasadny, K. R., Francis, I. R., Ross, C. W., Tuck, M., Regan, D., Fisher, S., Gutierrez, J., Kroll, S., Stagg, R., Tidmarsh, G., & Wahl, R. L.
Affiliations
University of Michigan (US)
Venue
Blood
Published
2000-08-15
Volume
96
Issue
4
Pages
1259-1266
ISSN
  • 0006-4971 (ISSN-L)
  • 1528-0020
OpenAlex
W1573890015
Cited by
525
References
56
Citations by year
2025: 1 · 2024: 9 · 2023: 7 · 2022: 7 · 2021: 4 · 2020: 13 · 2019: 7 · 2018: 7 · 2017: 11 · 2016: 15 · 2015: 14 · 2014: 17 · 2013: 14 · 2012: 21
FWCI
41.15
Type
journal article
Language
en
Open access
closed
Locations
  • Blood (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ca056794-08)
  • National Cancer Institute (R01-CA-56794, P01-CA-42678)
  • National Center for Research Resources (M-01RR00042, M01RR000042)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
  • Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
Keywords
radioimmunotherapy, iodine-131 tositumomab, B-cell non-Hodgkin lymphoma, relapsed/refractory lymphoma, autologous stem cell transplantation, progression-free survival, complete response, long-term follow-up, hematologic toxicity, human anti-mouse antibodies, thyroid-stimulating hormone, myelodysplastic syndrome
MeSH terms
Adult, Aged, Antibodies, Monoclonal, Female, Follow-Up Studies, Humans, Iodine Radioisotopes, Male, Middle Aged, Recurrence, Lymphoma, B-Cell, Radioimmunotherapy, Treatment Outcome, Antigens, CD20

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