REVIEW OF 5 CONSECUTIVE STUDIES OF RADIOLABELED IMMUNOGLOBULIN THERAPY IN HODGKINS-DISEASE

Recurrent Hodgkin's Disease (HD) provides unique opportunities to impr ove radiolabeled immunoglobulin therapy (RIT). Normal tissue toxicity after RIT is limited to bone marrow damage and is well documented and quantified in HD patients, Anti-antibody formation is rare in patients with HD, allowing for multiple RIT cycles, Overall, 134 patients with recurrent HD were treated on five different studies with i.v. antifer ritin, labeled with I-131 or with In-111 for diagnostic purposes and Y -90 for therapeutic purposes. Patients with recurrent, end-stage HD ob tain a 60% response rate following Y-90-labeled antiferritin, One-half of the therapy responses are complete, Responses are more common in p atients with longer disease histories (>3 years) and smaller tumor vol umes (<30 cm(3)) and in patients receiving at least 0.4 mCi Y-90-label ed antiferritin/kg body weight, Complete responders survive significan tly longer than partial responders (2 years versus 1 year), Partial re sponders survive longer than patients with progressive disease (1 year versus 4 months), HD in one-third of the patients recurs in new areas . A low protein dose (2-5 mg) and a moderate specific activity (10 mCi /mg) are recommended, Results obtained with Y-90-labeled antiferritin are significantly better than results with I-131-labeled antiferritin. Further translational research in vitro in the radiopharmacy and in v ivo with experimental animals is ongoing to improve the therapeutic re sults of RIT in HD, Obviously, many permutations of RIT cannot be expl ored in HD patients for ethical, financial, or logistic reasons, and p redictive preclinical research is required to achieve further progress , Currently, RIT is a low-toxicity, low-cost outpatient procedure for recurrent HD with a high response rate in a patient population with an unfavorable prognosis.