June 25, 2008
RIT and Stem Cell Transplant in AML
THERAPY In an article e-publishedon April 16 ahead of print in the International Journal of Hematology, Koenecke et al. from the Hannover Medical School (Germany) reported on radioimmunotherapy (RIT) with ^sup 188^Re-labeled antiCD66 antibody in preconditioning for allogenic stem cell transplantation in high-risk acute myeloid leukemia (AML). The study included 21 patients (14 with high-risk AML; 6 with AML after myelodysplastic syndrome; and I with advanced myelodysplastic syndrome). All received the ^sup 188^Re-labeled anti- CD66 antibody in the conditioning regimen for allogeneic stem cell transplantation. Eleven patients proceeded to standard full-dose conditioning with busulfan and high-dose cyclophosphamide, and 10 patients proceeded to a reduced-intensity conditioning regimen. Patients received an unmanipulated allogeneic graft from alternative donors ( 15 patients) or a human leukocyte antigen-identical family donor (6 patients). Disease-free survival over a median follow-up of 42 mo was 43%. Treatment-related mortality was 28.6% (6 patients), and an additional 6 patients died of relapsing disease within 385 d of transplantation. At the time the article was submitted for publication, 9 patients were in complete hematologic remission. The authors concluded that in this challenging disease setting, "The combination of RIT with chemotherapeutic conditioning seems to be a therapy with an acceptable risk of treatment-related morbidity and mortality as well as occurrence of severe acute graft-versus-host disease."International Journal of Hematology Copyright Society of Nuclear Medicine Jun 2008
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