Vriesendorp H M, Herpst J M, Leichner P K, Klein J L, Order S E
Department of Radiation Oncology, Johns Hopkins Oncology Center, Baltimore, MD 21205.
Int J Radiat Oncol Biol Phys. 1989 Oct;17(4):815-21. doi: 10.1016/0360-3016(89)90072-2.
Six patients with chemotherapy resistant Hodgkin's disease were treated with intravenous polyclonal 90-Yttrium (90Y) labeled antiferritin. Eighteen days after isotope infusion, patients received an autologous bone marrow transplant that was cryopreserved prior to initiation of treatment. Ten (one patient), 20 (four patients), or 30 mCi (two patients) were used. One patient received three cycles, three patients received two cycles, and two patients received one cycle. The same antibody labeled with 111-Indium (111In) was helpful in documenting the absence of anti-antibodies in six out of six patients, the presence of tumor targeting in six out of seven patients, and allowed for dose estimates in two out of six patients. One patient with a complete response received approximately 20 Gy to the tumor, whereas a second patient with 20 Gy to the tumor showed progressive disease. A total of three patients obtained a complete response, one had a partial response, and two patients progressed on treatment. Acute toxicity was limited to bone marrow aplasia, without a clear-cut beneficial effect for transplantation after 20 mCi 90Y and the suggestion of a positive effect after 30 mCi. One patient died in complete remission 26 months after treatment with chronic lung insufficiency, probably unrelated to the isotope treatment. The early observations are that 90Y-labeled antiferritin has a pronounced antitumor effect as a single agent and less normal tissue toxicity than other treatment modalities for Hodgkin's disease, such as chemotherapy, external beam radiotherapy, or autologous bone marrow transplantation after high dose chemo/radiotherapy.
6例化疗耐药的霍奇金病患者接受了静脉注射多克隆90钇（90Y）标记的抗铁蛋白治疗。同位素输注18天后，患者接受了在治疗开始前冻存的自体骨髓移植。使用的剂量分别为10毫居里（1例患者）、20毫居里（4例患者）或30毫居里（2例患者）。1例患者接受了3个疗程，3例患者接受了2个疗程，2例患者接受了1个疗程。用111铟（111In）标记的相同抗体有助于证实6例患者中有6例不存在抗抗体，7例患者中有6例存在肿瘤靶向性，并使6例患者中的2例能够进行剂量估算。1例完全缓解的患者肿瘤接受了约20 Gy的照射，而另1例肿瘤接受20 Gy照射的患者病情进展。总共有3例患者获得完全缓解，1例部分缓解，2例患者治疗期间病情进展。急性毒性仅限于骨髓再生障碍，20毫居里90Y治疗后对移植无明显有益效果，30毫居里治疗后有积极效果的迹象。1例患者在治疗后26个月因慢性肺功能不全在完全缓解期死亡，可能与同位素治疗无关。早期观察结果表明，90Y标记的抗铁蛋白作为单一药物具有显著的抗肿瘤作用，且与霍奇金病的其他治疗方式（如化疗、外照射放疗或高剂量化疗/放疗后的自体骨髓移植）相比，对正常组织的毒性较小。
