Myeloablative 131I-Tositumomab Radioimmunotherapy in Treating Non-Hodgkin's Lymphoma: Comparison of Dosimetry Based on Whole-Body Retention and Dose to Critical Organ Receiving the Highest Dose

Abstract Aim of the study to evaluate the role of PET/CT in initial diagnosis and staging of lymphoma, and to determine the predictive value of 18F-FDG PET by monitoring the early response and final response after completion of chemotherapy in patients with non-Hodgkin's lymphoma. Patient and Methods our prospective study included 25 patients with pathologically confirmed nonHodgkin Lymphoma diffuse large B cell lymphoma selected from Department of Radiology at Ain Shams University Hospital from January 2019 to March 2020. The patients included in this study performed the followings: Initial PET/CT for staging, interim PET/CT and end of the treatment PET/CT. We performed low dose non enhanced CT scan first, then a whole body PET study followed by diagnostic enhanced whole body CT scan. The whole study took approximately 20-30 minutes. Results PET/CT has greater sensitivity 100% and specificity 68.8% than CT alone for detecting sites of nodal and extra-nodal involvement and for assessment of therapeutic response in non-Hodgkin lymphoma. Conclusion PET / CT is an accurate method for evaluating tumor viability in the post-therapy setting of Non-Hodgkin lymphomas. PET / CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to contrast enhanced CT.

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Multicenter Phase II Clinical Study of Iodine-131–Rituximab Radioimmunotherapy in Relapsed or Refractory Indolent Non-Hodgkin’s Lymphoma

Journal of Clinical Oncology ◽

10.1200/jco.2005.05.3470 ◽

2006 ◽

Vol 24 (27) ◽

pp. 4418-4425 ◽

Cited By ~ 53

Author(s):

Michael F. Leahy ◽

John F. Seymour ◽

Rodney J. Hicks ◽

J. Harvey Turner

Keyword(s):

Hodgkin’S Lymphoma ◽

Progression Free Survival ◽

Complete Response ◽

Hodgkin's Lymphoma ◽

Whole Body ◽

Actuarial Survival ◽

Entire Cohort ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Iodine 131

Purpose To evaluate efficacy and safety of iodine-131 (131I) –rituximab chimeric anti-CD20 antibody radioimmunotherapy in patients with relapsed or refractory indolent non-Hodgkin's lymphoma (NHL). Patients and Methods After a standard loading dose of rituximab 375 mg/m2, individualized dosimetry was performed by whole-body gamma imaging of a tracer activity of 131I-rituximab followed by administration of a therapeutic activity of 131I-rituximab to deliver an estimated whole-body radiation absorbed dose of 0.75 Gy. Results Ninety-one patients were entered onto the trial: 78 patients (86%) had follicular lymphoma, six patients (7%) had mucosa-associated lymphoid tissue/marginal zone lymphoma, and seven patients (8%) had small lymphocytic lymphoma. The objective overall response rate (ORR) was 76%, with 53% attaining a complete response (CR) or CR unconfirmed (CRu). Median duration of response for patients achieving CR/CRu was 20 v 7 months for those with a partial response (P = .0121). Median progression-free survival for the entire cohort was 13 months, with 14% remaining relapse free beyond 4 years. Median follow-up was 23 months, with a 4-year actuarial survival rate of 59% ± 10%. Toxicity was principally hematologic; grade 4 thrombocytopenia occurred in 4% and neutropenia occurred in 16% of patients, with nadirs at 6 to 7 weeks after treatment. Conclusion 131I-rituximab radioimmunotherapy of relapsed or refractory indolent NHL achieves high ORR and CR rates with minimal toxicity.

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The Role of Ga-67 Whole-Body and Tc-99m DMSA Renal Scan in Primary Bilateral B-Cell Renal Non-Hodgkin's Lymphoma

Clinical Nuclear Medicine ◽

10.1097/00003072-199903000-00016 ◽

1999 ◽

Vol 24 (3) ◽

pp. 193-194 ◽

Cited By ~ 1

Author(s):

TZU-CHEN YEN ◽

KAI-YUAN TZEN ◽

KUN-JU LIN

Keyword(s):

B Cell ◽

Hodgkin’S Lymphoma ◽

Hodgkin's Lymphoma ◽

Whole Body ◽

Non Hodgkin’S Lymphoma ◽

Renal Scan ◽

Non Hodgkin's Lymphoma

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Bilateral Non-Hodgkin’s Lymphoma of the Temporal Bone: A Rare and Unusual Presentation

Case Reports in Otolaryngology ◽

10.1155/2016/2641876 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Sanjay Vaid ◽

Jyoti Jadhav ◽

Aparna Chandorkar ◽

Neelam Vaid

Keyword(s):

Computed Tomography ◽

Temporal Bone ◽

Hodgkin’S Lymphoma ◽

Hodgkin's Lymphoma ◽

Whole Body ◽

Excision Biopsy ◽

Primary Lymphoma ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Temporal Bones

Primary lymphoma of the temporal bone is an unusual finding in clinical practice and bilateral affection is even more rare. To the best of our knowledge, there are no reports of bilateral primary temporal bone lymphoma without middle ear involvement in the English medical literature so far. We report, for the first time, a case of primary lymphoma involving both temporal bones which presented with left-sided infranuclear facial palsy. A combination of contrast enhanced magnetic resonance imaging (MRI) and high resolution computed tomography (HRCT) was used to characterize and to map the extent of the lesion, as well as to identify the exact site of facial nerve affection. An excision biopsy and immunohistochemistry revealed diffuse large B-cell non-Hodgkin’s lymphoma (DLBCL). Whole body fluorodeoxyglucose (FDG) positron emission tomography-computed tomography study (PET-CT) was performed to stage the disease. The patient was treated with chemotherapy and radiation therapy and is now on regular follow-up. The patient is alive and asymptomatic without disease progression for the last twenty months after initial diagnosis.

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Phase I dose-escalation trial of iodine 131-labeled monoclonal antibody OKB7 in patients with non-Hodgkin's lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.1993.11.10.2021 ◽

1993 ◽

Vol 11 (10) ◽

pp. 2021-2029 ◽

Cited By ~ 39

Author(s):

M S Czuczman ◽

D J Straus ◽

C R Divgi ◽

M Graham ◽

P Garin-Chesa ◽

...

Keyword(s):

Bone Marrow ◽

Antitumor Activity ◽

Dose Escalation ◽

Hodgkin’S Lymphoma ◽

Hodgkin's Lymphoma ◽

Whole Body ◽

Fixed Dose ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Iodine 131

PURPOSE Eighteen patients with recurrent or refractory CD21-positive, non-Hodgkin's lymphoma (NHL) were treated in a phase IA dose-escalation therapeutic trial of iodine 131 labeled to a fixed dose of OKB7. METHODS Individual doses of 30 to 50 mCi of 131I on 25 mg OKB7 were administered 2 to 3 days apart to achieve four total 131I-OKB7 dose levels of 90, 120, 160, and 200 mCi. Pharmacology, dosimetry, therapeutic effects, toxicity, human anti-mouse antibody (HAMA) response, and maximum-tolerated dose (MTD) were determined. Patients were evaluated by imaging studies (including whole-body gamma camera or single-photon emission computed tomography [SPECT] scans), flow cytometric analysis, bone marrow biopsy, and serial blood sampling. RESULTS Median plasma and whole-body half-lives (T1/2) were 16 hours and 14 hours, respectively. Plasma and whole-body radiation doses were 0.0081 Gy/mCi and 0.0022 Gy/mCi, respectively. Specific tumor visualization was noted in eight of 18 patients. HAMA was detected in 12 of 16 patients. Nonhematologic toxicity was limited to asymptomatic elevations of thyroid-stimulating hormone (TSH) in five of 15 patients. Hematologic toxicity was observed in six of 18 patients, but was severe in only two patients. MTD in patients with diffuse lymphomatous bone marrow involvement was determined to be 200 mCi in four divided doses of 50 mCi 131I/25 mg OKB7. Antitumor activity was observed in 13 of 18 patients (one partial response [PR] and 12 mixed responses) and was dependent on the 131I-OKB7 dose administered. In general, palpable peripheral lymphadenopathy, enlarged spleens, skin lesions, and circulating OKB7-positive peripheral lymphocytes responded most readily to treatment. 131I-OKB7 was safely administered to a patient in leukemic phase of NHL with prompt subsequent loss of approximately 1 kg of tumor cells from the peripheral blood without associated tumor lysis syndrome. CONCLUSION Because antitumor activity with tolerable toxicity was observed in the majority of this group of heavily pretreated patients, phase II investigation of mAb OKB7 radioconjugates in the therapy of NHL is warranted.

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A preliminary study in treatment of non-Hodgkin's lymphoma by whole-body irradiation

Clinical Radiology ◽

10.1016/s0009-9260(76)80100-6 ◽

1976 ◽

Vol 27 (3) ◽

pp. 409-414 ◽

Cited By ~ 4

Author(s):

M.J. Garrett ◽

S. Das

Keyword(s):

Hodgkin’S Lymphoma ◽

Hodgkin's Lymphoma ◽

Whole Body ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Preliminary Study

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PET imaging in a longitudinal non-Hodgkin's lymphoma study: association with tumor volume

Acta Radiologica ◽

10.1258/ar.2011.110099 ◽

2011 ◽

Vol 52 (9) ◽

pp. 995-1002 ◽

Cited By ~ 4

Author(s):

Maija Rossi ◽

Pasi Korkola ◽

Hannu Pertovaara ◽

Ritva Järvenpää ◽

Prasun Dastidar ◽

...

Keyword(s):

Fdg Pet ◽

Hodgkin’S Lymphoma ◽

Laboratory Tests ◽

Tumor Volume ◽

Volume Reduction ◽

Hodgkin's Lymphoma ◽

Whole Body ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Tumor Volume Reduction

Background Computed tomography (CT) is generally used in the evaluation of the treatment response of non-Hodgkin's lymphoma (NHL) patients. Instead of morphological images, positron emission tomography (PET) shows metabolic information that is connected to tumor activity, cell proliferation rate, and, thus, prognosis. Purpose To determine the prognostic value of PET for tumor volume reduction measured by CT and magnetic resonance imaging (MRI) along with clinical characteristics in NHL patients. Material and Methods We imaged 21 B-cell type NHL patients using whole-body 18F-FDG-PET at the onset and the completion of treatment and at six-month follow-up. The maximum standardized uptake value (SUVmax) was calculated. Morphological tumor volume calculations were assessed using both MRI and CT. Additionally, patients underwent thorough clinical examination including several laboratory tests. Results A high SUVmax was able to predict significant tumor volume reduction at the beginning of treatment, but the relation to pure tumor volume was poor. Conclusion The SUVmax values derived from FDG-PET seemed to correlate with volume changes but not with their absolute values or laboratory tests. Unlike MRI and CT, FDG-PET showed the disappearance of active tumors after treatment.

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Low dose fractionated whole body irradiation in the treatment of advanced non-Hodgkin's lymphoma

Cancer ◽

10.1002/1097-0142(197905)43:5<1636::aid-cncr2820430512>3.0.co;2-e ◽

1979 ◽

Vol 43 (5) ◽

pp. 1636-1642 ◽

Cited By ~ 49

Author(s):

Noah C. Choi ◽

Adrian R. Timothy ◽

Sheldon D. Kaufman ◽

Robert W. Carey ◽

Alan C. Aisenberg

Keyword(s):

Hodgkin’S Lymphoma ◽

Low Dose ◽

Hodgkin's Lymphoma ◽

Whole Body ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

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Clinical Utility of Radioimmunoscintigraphy of Non-Hodgkin's Lymphoma with Radiolabelled LL2 Monoclonal Antibody., Lymphoscan™: Preliminary Results

Tumori Journal ◽

10.1177/030089169508100304 ◽

1995 ◽

Vol 81 (3) ◽

pp. 173-178 ◽

Cited By ~ 4

Author(s):

Massimo Gasparini ◽

Emilio Bombardieri ◽

Carlo Tondini ◽

Lorenzo Mattioli ◽

Lynne Hughes ◽

...

Keyword(s):

Monoclonal Antibody ◽

Hodgkin’S Lymphoma ◽

B Cell Lymphoma ◽

Hodgkin's Lymphoma ◽

Clinical Staging ◽

Whole Body ◽

Low Grade ◽

Fab Fragment ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

Aims and Background Adequate clinical staging of non-Hodgkin's lymphoma patients is essential because only localized disease can be treated satisfactorily. Many imaging procedures are necessary to stage the disease accurately. The objective of this study was to evaluate the efficacy of an anti-lymphoma antibody in the Fab’ fragment form, labelled with 99mTc, to detect malignant lesions. Methods Radioimmunodetection (RAID) with 99mTc-labelled B-cell lymphoma monoclonal antibody IMMU-LL2-Fab’ (LymphoSCAN™; Immunomedics, Morris Plain, NJ, USA) was investigated in 10 patients (5 females and 5 males; age range, 20-72 years) with histologically proved non-Hodgkin's lymphoma. Of the 10 lymphomas, 7 were intermediate grade and 3 were low grade. Whole body images with multiple planar views were obtained at 30 min, 4-6 and 24 h after i.v. injection of 1 mg LL2-Fab’ labelled with 740-925 MBq of 99mTc. SPET of the chest or abdomen was performed in all patients 5-8 h after the immunoreagent injection. Results No adverse reactions were observed in any patient after Mab infusion, and no appreciable changes were seen in the blood counts, renal or liver function tests. A total of 18 of 21 (85.7%) lymphoma lesions were detected by RAID. All the tumor localizations were confirmed by clinical examination and with other imaging techniques, such as CT scan, MRI or gallium scan. In this series of patients no false-positive results were noted. As regards the biodistribution of the immunoreagent, no appreciable bone marrow activity was seen; splenic targeting was demonstrated in all patients; the tumor-to-non-tumor ratios ranged from 1.2 to 2.8 ad measured by the ROI technique; no difference in uptake was noted for different tumor grades. The images obtained 24 h after injection did not reveal new lesions, but areas of doubtful uptake were seen as positive focal areas in the delayed scan. Conclusions LymphoSCAN™ seems to be useful for detection, staging and follow-up of non-Hodgkin's lymphoma patients.

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