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Direct Intralymphatic Injection of Radiolabeled ¹¹¹In-T101 in Patients with Cutaneous T-Cell Lymphoma¹

National Cancer Institute-Navy Medical Oncology Branch, Clinical Oncology Program, Division of Cancer Therapy, National Cancer Institute [J. L. M., P. A. B., E. S., J. E.], Department of Nuclear Medicine [J. A. C., A. M. K., J. C. R., P. P.] and Department of Radiology [J. H.], Warren C. Magnuson Clinical Center, National Institutes of Health, and Laboratory of Mathematical Biology, National Cancer Institute [J. N. W.], National Institutes of Health, Bethesda, Maryland 20814; Division of Medical Oncology, University of Colorado Cancer Center and Health Service Center, Denver, Colorado 80262 [P. A. B.] Department of Pathology, Naval Hospital, Bethesda, Maryland 20814 [J. D. C.]; and Biological Response Modifier Program, Frederick Cancer Research Center, Divisions of Cancer Treatment, National Cancer Institute, National Institutes of Health, Frederick, Maryland 21701 [C. P.]; Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021 [S. M. L.]

Direct intralymphatic administration of radiolabeled monoclonal antibody in targeting antigen-bearing lymphoma cells in regional lymph nodes of patients with cutaneous T-cell lymphoma was evaluated. Seven consecutive patients undergoing staging lymphangiography received intralymphatic infusions of ¹¹¹In-T101 to evaluate lymph node involvement. This procedure was accomplished without significant complication. The ¹¹¹In-T101 rapidly distributed throughout the regional lymphatic compartment and passed into the systemic circulation. Tumor-bearing sites in the inguinal-femoral lymph nodes retained from 0.42 to 4.8% of the injected dose of radiolabeled antibody. Three patients were upstaged to Stage IVA based on tumor involvement found after radiolymphoscintigraphy-directed biopsy of groin lymph nodes, selected because of intense radioactivity by gamma camera imaging. Compared with previously reported s.c. antibody administration, there was a marked reduction in the radioactive exposure of normal tissues at the injection sites in the lower extremities. Direct intralymphatic delivery of ¹¹¹In-T101 appears to be a feasible, efficient method for delivering therapeutic doses of radiolabeled antibody.

¹ The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Navy, the Department of Defense, or the Department of Health and Human Services.

² To whom requests for reprints should be addressed, at National Cancer Institute, NCI-Navy Medical Oncology Branch, Naval Hospital Bethesda, Bldg. 8, Rm. 5101, Bethesda, MD 20814.

³ Present address: Nuclear Medicine/Radiology Department, Hospital of the University of Pennsylvania, 3400 Spruce St. Philadelphia, PA 19104.

Received 12/11/89. Accepted 10/23/90.

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