Polyclonal 90Yttrium labeled antiferritin for refractory Hodgkin's disease

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.