Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Anti-B4 (CD 19) monoclonal antibody, conjugated with ricin (B4-blocked ricin: B4bR) in refractory AIDS-lymphoma (Meeting abstract).
Proc Annu Meet Am Soc Clin Oncol; 13:A10 1994. Unique Identifier : AIDSLINE ICDB/94600007 Tulpule A; Anderson LJ; Levine AM; Espina B; Esplin J; Boswell W; Scadden D; Esseltine D; Epstein CL; Univ. Southern Calif School of Medicine, Los Angeles, CA
Abstract:
Prognosis for pts with relapsed or refractory AIDS-lymphoma is very poor, with median survival only 2 to 3 months, despite further chemotherapy. In an attempt to seek alternative modalities of treatment, anti-B4bR was employed in 9 pts. A murine IgG1 monoclonal antibody against the CD19 antigen, present on normal B cells, and on B cell lymphomas was conjugated to the potent toxin, ricin; and was administered as a continuous infusion over 28 days, at escalating doses per cohort of 3 pts beginning at 5 ug/kg/day; 10 ug and then 20 ug/kg/day. All pts were male. Median CD4 cells at start of B4bR was 82/dl (r = 6-427). AIDS other than lymphoma was present in 2 pts prior to B4bR. Number of chemo regimens prior to B4bR was 1 in 2 pts; 2 in 5 pts; and 4 in 2 pts; only 3 pts had attained initial CR to front-line chemotherapy. Stage IV disease was present in 8/9. High grade small non-cleaved lymphoma was present in 6, with intermediate grade large cell lymphoma in 3. A median of 0.8 courses of B4bR was administered (0.4 to 1.75) per pt. Toxicity included mild to moderate increase in liver enzymes (N=5). Complete remission of a large rectal mass was seen in 1 pt; solid partial remission of liver lesions was seen in 1, for response rate of 2/9 (22%). A mixed response was seen in 1, and others had progressive disease. Human anti-mouse antibodies (HAMA) developed in 1, while anti-ricin antibodies (HARA) occurred in 2 pts, limiting further immunoconjugate administration. Median survival from institution of Rx is 6.6 mo. We conclude: (1) B4bR, when given at low dosages over prolonged periods (28 days) is associated with acceptable toxicity in pts with relapsed or refractory Aids-lymphoma; (2) B4bR may be associated with significant tumor responses; (3) further pt accrual is on-going.
Keywords: Antibodies, Monoclonal/IMMUNOLOGY/*THERAPEUTIC USE Antigens, CD/*IMMUNOLOGY Antigens, Differentiation, B-Lymphocyte/*IMMUNOLOGY Dose-Response Relationship, Drug Drug Administration Schedule Follow-Up Studies Human Infusions, Intravenous Lymphoma, AIDS-Related/MORTALITY/PATHOLOGY/*THERAPY Male Neoplasm Staging Ricin/*THERAPEUTIC USE Survival Rate ABSTRACT 940830
M9480775
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
