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Treatment of Refractory Hodgkin's Lymphoma Patients With an Iodine-131–Labeled Murine Anti-CD30 Monoclonal Antibody

From the Department of Internal Medicine I, Department of Nuclear Medicine, University of Cologne, Germany; Hopital Huriez, Lille, France; Department of Radioimmunotherapy, City of Hope National Medical Center, Duarte, CA

Address reprint requests to A. Engert; Klinik I fuer Innere Medizin, Universitaet zu Koeln, Joseph-Stelzmann-Strasse 9, D-50924 Koeln, Germany; e-mail: a.engert{at}uni-koeln.de

PURPOSE: Hodgkin's lymphoma (HL) has been demonstrated to be a good target for immunotherapy since lymphocyte activation markers such as CD30 are expressed in high numbers on the malignant cells. Thus, we developed a new radioimmunoconjugate consisting of the murine anti-CD30 monoclonal antibody (MAb) Ki-4 labeled with iodine-131 (¹³¹I).

PATIENTS AND METHODS: The biodistribution of ¹³¹I–Ki-4 was assessed via dosimetry after preinfusion of 5 mg native Ki-4 followed by 250 to 300 MBq ¹³¹I-labeled Ki-4. Whole-body scintigraphy was performed 1 hour, 24 hours, 48 hours, 72 hours, and 6 days after the infusion. Dosimetry was calculated using the programs NucliDose ICON-IDL (version 5.0.2; Siemens, Erlanger, Germany) and MIRDOSE (version 3.1; Oak Ridge National Laboratories; Oak Ridge, TN). The therapeutic dose was given on day 8 after preinfusion of unlabeled Ki-4.

RESULTS: We treated 22 patients with relapsed or refractory CD30-positive HL. Preinfusion of 5 mg native Ki-4 was sufficient to bind the soluble CD30. Imaging demonstrated localization of involved areas measuring 5 cm in diameter or more in four patients and 2.5 cm in one patient. Patients received total body doses of 0.035 Gy to 0.99 Gy. Acute toxicity was mild with grade 1 fatigue in 19 of 22 assessable patients. Seven patients experienced grade 4 degrees hematotoxicity 4 to 8 weeks after treatment. Response included one complete remission, five partial remissions, and three minor responses.

CONCLUSION: Treatment with ¹³¹I–Ki-4 is effective but can be associated with severe hematotoxicity.

Supported in part by Deutsche Krebshilfe, grant 10-1899-En3, and Koeln Fortune program, Faculty of Medicine, University of Cologne, grant 149/2001.

Presented, in part, as oral presentation at the 42nd Annual Meeting of the American Society of Hematology, Philadelphia, PA, December 6-10, 2002, and the 16th Annual Congress of the European Association of Nuclear Medicine, Amsterdam, the Netherlands, August 23-27, 2003.

R.S. and M.D. contributed equally to this work.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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