RECURRENCE OF HODGKINS-DISEASE AFTER IN-111 AND Y-90 LABELED ANTIFERRITIN ADMINISTRATION

BACKGROUND. Indium-111 labeled antiferritin targets 95% of all Hodgkin 's disease lesions with a diameter of 1 cm or more. Subsequent treatme nt with yttrium-90 labeled antiferritin secures a high response rate i n patients with recurrent Hodgkin's disease. METHODS. A total of 87 pa tients were entered on one of three different yttrium-90 labeled antif erritin protocols. Recurrences after yttrium-90 treatment were analyze d. Nine patients were retreated with involved external beam radiation fields, selected with the help of indium-111 labeled antiferritin. RES ULTS. In single-agent yttrium-90 antiferritin studies, a response rate of more than 60% was found, with an average response duration of 6 mo nths. One-third of the patients had recurrences in previously uninvolv ed areas. Repeat indium antiferritin scintigraphy allowed for the sele ction of new radiation fields for recurrences. In-field disease contro l was obtained for a median of 8 months, but new recurrences in new ar eas occurred. Chemotherapy or radiation therapy given immediately befo re antiferritin decreased tumor targeting with indium-111 labeled anti ferritin. CONCLUSIONS. Recurrences after radiolabeled antiferritin tre atment are not due to radioresistant Hodgkin's disease. In contrast, H odgkin's disease less than 1 cm in diameter is not targeted and not co ntrolled by radiolabeled antiferritin. New multimodality regimens with a higher therapeutic ratio are needed for treatment of Hodgkin's dise ase with curative intent. Radiolabeled antiferritin can be incorporate d in such regimens to secure better control of bulky Hodgkin's disease (> 1 cm in diameter), but it should be given before chemotherapy or r adiation therapy. (C) 1997 American Cancer Society.