Abstract:
:The emergence of radioimmunotherapy (RIT) provides a new therapeutic approach in which monoclonal antibodies directed against tumor-specific antigens are used to target therapeutic radioisotopes to sites of disseminated disease. The target cell is eliminated and adjacent tumor cells, to which antibody has not bound, are also killed. To date, 90Y-ibritumomab tiuxetan and 131I-tositumomab are the only FDA-approved, and most extensively studied, radioimmunoconjugates for RIT of non-Hodgkin's lymphoma (NHL). Both 90Y-ibritumomab tiuxetan and 131I-tositumomab utilize an anti-CD20 monoclonal antibody to target radioactivity to malignant B-cells. 90Y-ibritumomab tiuxetan emits pure therapeutic beta radiation, permitting outpatient treatment. The high energy of the beta particles emitted by 90Y (2.3 MeV) achieves a wide-ranging crossfire effect. Approximately 90% of the energy is deposited within 5 mm of the radiation source, which kills not only antibody-bound cells but also neighboring malignant cells within a diameter of up to 12 mm. In addition, the half-life of 90Y matches the in vivo biological half-life of the monoclonal antibody (64 h), with negligible excretion of 90Y in urine. With 90Y-ibritumomab tiuxetan, hematological adverse events correlate with the degree of bone marrow involvement and the bone marrow reserve, rather than with dosimetric parameters, and doses to normal organs and red marrow are well below the accepted limits of 20 Gy to normal organs and 3 Gy to red marrow. A dosing schedule based on patient weight and baseline platelet counts has therefore been developed, and dosimetry is not routinely required. 131I, the isotope used in tositumomab RIT, emits both therapeutic beta radiation and highly penetrating gamma emissions. The lower energy of the beta particles emitted by 131I (0.6 MeV) achieves a crossfire effect of up to 2 mm in diameter, which is used to treat tumors. The gamma radiation emitted by 131I allows both dosimetry and biodistribution studies to be performed; such studies are important because the rate of 131I-tositumomab clearance varies among individuals. Therefore, dosimetry must be performed in each patient before the therapeutic dose of 131I-tositumomab is administered. Similarly, because of this variability in 131I clearance, the dosage of 131I-tositumomab is calculated accordingly for each patient. 131I-tositumomab is a substrate for dehalogenases, which decouple the radioisotope from the antibody moiety, resulting in free, circulating 131I, which can accumulate in the thyroid. Patients who receive 131I-tositumomab therapy are usually hospitalized in radioprotection wards, and are treated by specially trained hospital staff. The administration of RIT requires an integrated team approach, involving nuclear medicine (or, in some countries, radiation oncology), hematology-oncology, nursing, radiopharmacy and radiation safety personnel. Effective collaboration between all members of the RIT team is essential to treatment success, and understanding the properties of these novel agents will facilitate their safe and effective administration.
journal_name
Leuk Lymphomajournal_title
Leukemia & lymphomaauthors
Bischof Delaloye Adoi
10.1080/10428140310001616935keywords:
subject
Has Abstractpub_date
2003-01-01 00:00:00pages
S29-36eissn
1042-8194issn
1029-2403journal_volume
44 Suppl 4pub_type
杂志文章,评审abstract::The aim of the present study was to evaluate the feasibility and response of the Dexa-BEAM regimen as a salvage therapy followed by high-dose chemotherapy (HDCT) with peripheral blood stem cell transplantation (PBCST) in responding patients with high-grade relapsed or resistant aggressive non-Hodgkin's lymphoma (NHL)....
journal_title:Leukemia & lymphoma
pub_type: 临床试验,杂志文章
doi:10.3109/10428199909058430
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abstract::The objective of this work was to determine the safety and efficacy of gemtuzumab ozogamicin in patients with poor prognosis acute myeloid leukemia (AML). Patients with the following diagnoses/characteristics were treated with 1-3 infusions of gemtuzumab ozogamicin at a dose of 9 mg/m2: (1) relapse of AML < or = 6 mon...
journal_title:Leukemia & lymphoma
pub_type: 临床试验,杂志文章
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abstract::The treatment of chronic myelogenous leukemia (CML) with specific tyrosine kinase inhibitors typically results in clinical success, although therapeutic failure frequently occurs. In order to investigate the biological consequences of treating CML cells with such drugs, we previously reported that the antioxidant sele...
journal_title:Leukemia & lymphoma
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abstract::There is little evidence about whether additional risk stratification for adult patients with acute lymphoblastic leukemia age 65 and older is warranted. Using the Surveillance, Epidemiology, and End Results data linked to Medicare claims, we examined the effects of age, comorbid conditions, and mobility limitations o...
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abstract::The clinical significance and mechanisms of TET2 are not well defined in myeloid malignancies. We detected TET2 mutations and assayed its catalyzing conversion product 5-hydroxymethylcytosine (5-hmC) in 61 Chinese patients with MDS. Ten patients were identified to have TET2 mutations (16.4%). 5-hmC levels in patients ...
journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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abstract::Graft-versus-host disease (GVHD) represents the major barrier to successful allogeneic bone marrow transplantation. Positive and negative selection studies have unequivocally demonstrated that donor T cells are responsible for the induction phase of GVHD. Inhibition of the early steps of T cell antigen recognition lea...
journal_title:Leukemia & lymphoma
pub_type: 杂志文章,评审
doi:10.3109/10428199609054796
更新日期:1996-09-01 00:00:00
abstract::Nucleoside analogs are important components of treatment regimens for acute leukemia in adults. Plasma membrane permeation of the nucleoside analog molecules, the initial event in the cellular conversion of nucleosides to active agents, is mediated by nucleoside-specific membrane transporters. The widely-expressed es ...
journal_title:Leukemia & lymphoma
pub_type: 杂志文章,评审
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章,评审
doi:10.3109/10428194.2016.1146949
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章
doi:10.1080/10428194.2020.1864351
更新日期:2021-01-25 00:00:00
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章
doi:10.3109/10428194.2012.746684
更新日期:2013-08-01 00:00:00
abstract::Abstract Increasing manganese superoxide dismutase (MnSOD) expression can suppress the malignant phenotype in various cancer cell lines and suppress tumor formation in xenograft and transgenic mouse models. A mimic of manganese superoxide dismutase (MnSODm), synthesized by a chemical method, has been shown to possess ...
journal_title:Leukemia & lymphoma
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doi:10.3109/10428194.2013.825904
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journal_title:Leukemia & lymphoma
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doi:10.3109/10428194.2010.531410
更新日期:2011-01-01 00:00:00
abstract::Akt (protein kinase B) is a serine/threonine kinase involved in the regulation of cell survival signals. Akt is expressed in T- and B-lymphocytes and is activated in response to cytokine and antigen-receptor stimulation. Three isoforms of Akt have been identified, Akt-1, -2 and -3, but the expression pattern and speci...
journal_title:Leukemia & lymphoma
pub_type: 杂志文章
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abstract::Our aim was to describe a large population-based cohort of diffuse large B-cell lymphoma (DLBCL) during the last decade, evaluating possible improvement in survival and to identify subgroups in need of novel treatment strategies. The study population encompassed all patients diagnosed with DLBCL in Sweden from 2000 th...
journal_title:Leukemia & lymphoma
pub_type: 杂志文章
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更新日期:2014-08-01 00:00:00
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章,评审
doi:10.3109/10428190109064582
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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doi:10.1080/10428190410001687512
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
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journal_title:Leukemia & lymphoma
pub_type: 杂志文章,多中心研究
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journal_title:Leukemia & lymphoma
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