RATIONALE: Radiolabeled monoclonal antibodies can find cancer cells and carry cancer-killing substances to them without harming normal cells. This may be effective treatment for leukemia. PURPOSE: This phase I trial is studying the best dose of yttrium Y 90-labeled monoclonal antibody BU-12 in treating patients with advanced relapsed or refractory acute lymphoblastic leukemia or chronic lymphocytic leukemia.
OBJECTIVES: Primary * To determine the biodistribution of indium-111 BU-12 in patients with refractory CD19+ leukemia. Secondary * To determine the maximum tolerated dose of yttrium Y 90 anti-CD19 antibody BU-12 * Determine the human anti-mouse antibody (HAMA) response. * To define, preliminarily, the antitumor activity of yttrium Y 90 anti-CD19 antibody BU-12. OUTLINE: Patients receive yttrium Y 90 anti-CD19 antibody BU-12/indium-111 BU-12 IV over 60 minutes on day 0 and undergo whole-body imaging on days 0, 1, 3, 4, and 7. Patients also undergo blood collection and bone marrow biopsy periodically for dosimetry calculations and pharmacokinetics. After completion of study treatment, patients are followed periodically for 2 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
1
Patients in whom the biodistribution is as expected (unaltered) AND a HAMA response does not develop will receive a single dose of 90Y-BU-12 in a dose escalated manner to establish the maximum tolerated dose (MTD) of 90Y-BU-12 over 60 minutes on Day 0. A single course of BU-12 includes the imaging dose of 111In-BU-12 followed 7-8 days later by the therapy dose of 90YBU- 12.
Patients receive indium-111 BU-12 IV over 60 minutes on day 0
Masonic Cancer Center at University of Minnesota
Minneapolis, Minnesota, United States
Biodistribution of indium-111 BU-12
Perform a whole body scan acquiring both anterior and posterior images at a speed of 10 cm/min (20 minute scan) using a medium energy collimator, a 256 x 1024 computer acquisition matrix and acquisition photo peak settings of 172 and 247 keV with 15% windows.
Time frame: Immediately post infusion, 4-6 hours after infusion and Days 1, 3, 4 and 7 after infusion
Maximum tolerated dose of yttrium Y 90 anti-CD19 antibody BU-12
DLT will be defined as bone marrow aplasia \> 6 weeks duration from the first treatment day; specifically, failure to recover peripheral ANC \> 500/μL and platelets \> 20,000/μL documented by bone marrow aplasia, not malignant infiltration - Any NCI CTCAE v 3.0 grade 3 non-hematologic toxicity except for allergic reactions to radiolabeled BU-12 will be dose limiting. If the BU-12 antibody is very allergenic, then ≥ grade 3 allergic reactions will be dose limiting.
Time frame: Beginning Day 1 of treatment
Presence or absence of a human antibody to murine antibody
Presence or absence of a human antibody to murine antibody at baseline, 28 and 60 days post therapy, and at 6 months post therapy
Time frame: baseline, 28 and 60 days post therapy, and at 6 months post therapy
Number of Patients by Clinical Response
Patients evaluable for DLT will be assessed for response at day 28 and day 60 post therapy dose (event is whether or not the patient has a Complete Remission, Partial Remission, Stable Disease, Refractory Disease, Relapsed Disease). The proportion of patients by disease status will be reported.
Time frame: day 28 and day 60
Time to Clinical Response
Time-to-event will be measured from date of therapy dose.
Time frame: Day 28, 60, 6 Months
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