Article Figures & Data
Figures
- FIGURE 1.
Complete metabolic response after CXCR4-directed RLT as conditioning regimen before allogeneic HSCT (patient 4). Maximum-intensity projections and transaxial CXCR4-directed 68Ga-pentixafor PET/CT before (left) and 4 mo after (right) CXCR4-directed RLT using 90Y-pentixather. Before therapy, patient demonstrated multiple CXCR4-positive sites of disease, including nodal, peritoneal, and osseous manifestations, whereas posttherapy imaging revealed complete response. Timeline of treatment is also displayed.
- FIGURE 2.
Time course of lactate dehydrogenase (LDH) (in U/L) as indicator of early response to CXCR4-directed RLT. Dotted lines indicate RLT, start of conditioning therapy (CON), start of high-dose therapy (HDT), or start of HSCT. Patient 1 (A) showed rapid and continuous decline in LDH after CXCR4-RLT. Before next therapeutic steps, patient 2 (B) and patient 4 (D) exhibited remarkable increase in LDH, followed by massive decline, supporting notion of immediate response to CXCR4-directed RLT in those 3 patients. Patient 3 (C), however, demonstrated modest LDH fluctuations between RLT and CON.
Tables
Patient no. Sex Age (y) Disease State of disease before RLT Additional radioimmunotherapy HSCT RLT to neutropenia (d) HSCT to neutrophil reconstitution (d) Best response PFS OS 1 F 50 T-PLL PD No Allogeneic 10 NA* NA* NA* 16 d 2 M 53 TCL (NOS) PD No Autologous 11 NA† PR 7 mo 56 mo 3 M 50 TCL (hepatosplenic/NOS) PD Yes (188Re) Allogeneic 11 12 CMR 25 mo 54 mo‡ 4 F 43 T-cell lymphoblastic lymphoma PD No Allogeneic 14 12 CMR 4 mo‡ 4 mo‡ * Patient 1 died after RLT and HSCT, without reaching neutrophil reconstitution.
↵†Neutrophil reconstitution was not immediately successful after autologous HSCT but was reached after another conditioning therapy and allogeneic HSCT.
↵‡Complete metabolic response at last available follow-up.
PFS = progression-free survival; OS = overall survival; T-PLL = T-cell prolymphocytic leukemia; PD = progressive disease; NA = not available; NOS = not otherwise specified; PR = partial response; CMR = complete metabolic response.
Patients 2–4 were alive at last available follow-up.
Parameter Site Patient 1 2 3* 4 Pretherapeutic dosimetry Activity (MBq of 177Lu-pentixather) 200 225 205 210 Specific absorbed dose (Gy/GBq 177Lu) Kidneys 1.1 1.1 0.8 1.6 Liver 0.5 0.4 0.3 0.5 Spleen 1.0 0.8 0.3 0.5 Bone marrow 0.6 0.6 0.4 0.3 Extramedullary lesion 1.6 1.4 1.9 Kinetics converted to 90Y† (Gy/GBq 90Y) Kidneys 4.5 4.8 3.7 5.8 Liver 1.6 1.4 0.9 1.3 Spleen 2.7 3.3 0.9 1.3 Bone marrow 1.4 1.5 1.3 1.0 Extramedullary lesion 4.2 4.6 7.3 RLT Activity (GBq 90Y-pentixather) 4.2 4.9 5.1 4.6 Absorbed dose† (Gy) Kidneys‡ 11.2 14.0 11.3 15.9 Liver 6.6 6.6 4.4 5.9 Spleen 11.2 16.4 4.6 6.2 Bone marrow 5.6 7.2 6.5 4.8 Extramedullary lesion 17.4 22.4 33.2
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