Use of Iodine ¹³¹I-Tositumomab Radioimmunotherapy in a Patient with Waldenstrom's Macroglobulinemia

Donald E Tsai Bone Marrow and Stem Cell Transplant Program, University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania, 19104, USACorrespondence[email protected]

Ivan Maillard Division of Nuclear Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, 19104, USA

Lisa H Downs Department of Radiation Oncology, University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania, 19104, USA

Abass Alavi Bone Marrow and Stem Cell Transplant Program, University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania, 19104, USA

Sunita D Nasta Division of Nuclear Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, 19104, USA

Eli Glatstein Department of Radiation Oncology, University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania, 19104, USA

Stephen J Schuster Bone Marrow and Stem Cell Transplant Program, University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania, 19104, USA

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Abstract

Waldenstrom's macroglobulinemia is an indolent B-cell malignancy that is characterized by high levels of IgM paraprotein production and is incurable with standard chemotherapy. Iodine ¹³¹I-Tositumomab (iodine-131-labeled murine anti-CD20 monoclonal antibody; Bexxar) is a novel radioimmunotherapeutic agent that has a high response rate in relapsed or chemotherapy refractory, CD20-positive, low grade or transformed B-cell non-Hodgkin's lymphomas. There are no data on the use of radioimmunotherapy in Waldenstrom's macroglobulinemia. We report a patient with Waldenstrom's macroglobulinemia with transformation to a large B-cell lymphoma, who was treated successfully with iodine ¹³¹I-tositumomab. The patient had a complete response to the treatment, including disappearance of any detectable IgM paraprotein. This case report demonstrates the potential for radioimmunotherapy in CD20 positive B-cell malignancies.

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Use of Iodine ¹³¹I-Tositumomab Radioimmunotherapy in a Patient with Waldenstrom's Macroglobulinemia

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Use of Iodine 131I-Tositumomab Radioimmunotherapy in a Patient with Waldenstrom's Macroglobulinemia

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Use of Iodine ¹³¹I-Tositumomab Radioimmunotherapy in a Patient with Waldenstrom's Macroglobulinemia