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Radiation dosimetry results for zevalin radioimmunotherapy of rituximab‐refractory non‐hodgkin lymphoma
Author(s) -
Wiseman Gregory A.,
Leigh Bryan,
Erwin William D.,
Lamonica Dominick,
Kornmehl Ellen,
Spies Stewart M.,
Silverman Daniel H. S.,
Witzig Thomas E.,
Sparks Richard B.,
White Christine A.
Publication year - 2002
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10305
Subject(s) - radioimmunotherapy , ibritumomab tiuxetan , medicine , nuclear medicine , rituximab , dosimetry , lymphoma , cd20 , biodistribution , bone marrow , non hodgkin's lymphoma , pathology , monoclonal antibody , immunology , in vivo , antibody , microbiology and biotechnology , biology
BACKGROUND Zevalin consists of a murine anti‐CD20 monoclonal antibody (ibritumomab) conjugated to the linker‐chelator tiuxetan, which securely chelates indium‐111 ( 111 In) for imaging and dosimetry and yttrium‐90 ( 90 Y) for radioimmunotherapy (RIT). Previous trials involving rituximab‐naïve patients have demonstrated excellent targeting of Zevalin to CD20+ B‐cell non‐Hodgkin lymphoma with minimal uptake in normal organs. The purpose of this trial was to perform 111 In‐Zevalin imaging in patients with rituximab‐refractory tumors to determine normal organ dosimetry. METHODS Twenty‐seven patients were given an imaging dose of 5 mCi (185 MBq) 111 In‐Zevalin on Day 0, evaluated with dosimetry, and then given a therapeutic dose of 0.4 mCi/kg (15 MBq/kg) 90 Y‐Zevalin on Day 7. Both Zevalin doses were preceded by an infusion of 250 mg/m 2 rituximab to clear peripheral B cells and improve Zevalin biodistribution. Residence times for 90 Y in blood and major organs were estimated from 111 In biodistribution, and the MIRDOSE3 computer software program was used to calculate absorbed radiation doses to organs and red marrow. RESULTS Median estimated absorbed radiation doses from 90 Y‐Zevalin were 8.1 Gray (Gy) (range, 4.2–23.0 Gy) to the spleen, 5.1 Gy (range, 2.6–12.0 Gy) to the liver, 2.0 Gy (range, 1.4–5.3 Gy) to the lungs, 0.22 Gy (range, < 0.01–0.66 Gy) to the kidneys, and 0.74 Gy (range, 0.29–1.2 Gy) to the red marrow. These results are consistent with those from earlier Zevalin trials in rituximab‐naïve patients. Hematologic toxicity was manageable and did not correlate with estimates of red marrow or total‐body absorbed radiation dose. CONCLUSIONS Zevalin treatment of rituximab‐refractory follicular NHL patients at 0.4 mCi/kg resulted in acceptable estimates of absorbed radiation dose to organs, similar to those observed in other Zevalin‐treated populations. Cancer 2002;94:1349–57. © 2002 American Cancer Society. DOI 10.1002/cncr.10305