Nachweis des Skelettbefalls maligner Erkrankungen durch Immunszintigraphie des Knochenmarks

Malignant lymphoma of bone is rare. In many cases, its diagnosis is delayed because of unspecific clinical signs and equivocal radiographs. Therapy in general is multimodal, including surgery and radio- and chemotherapy. Our objective was to demonstrate the clinical and radiological aspects of the lesion to optimize diagnostic approaches and to evaluate treatment and prognostic factors. Thirty-six patients with malignant lymphoma of bone who were surgically treated over a 15-year-period were retrospectively reviewed. Seventeen of them showed a singular bone non-Hodgkin's lymphoma (NHL) which was classified as primary lymphoma of the bone (PLB). In 13 cases, dissemination of the disease with multiple bone or visceral involvement was apparent (dNHL). Six patients suffered from bone involvement due to Hodgkin's disease (HD). Surgical treatment was indicated for diagnostic reasons or complications due to the disease. Radiation and chemotherapy were part of the oncological treatment. The patients' mean age was 57 years. The main symptom in malignant bone lymphoma in 33 patients was pain, with an average duration of 8 months. In the secondary cases, bone involvement appeared on average 57 months after the initial diagnosis. An osteolytic pattern was seen in 58% of the lesions. Soft-tissue involvement was seen in 71% of cases (PLB 80%, dNHL 73%, HD 40%) and was the primary diagnostic sign associated with this disease. The 5-year survival rate was 61% (PLB 88%, dNHL 38%, HD 50%). Multiple vs solitary bone involvement was the most significant factor in the prognosis. Extraskeletal involvement significantly decreased survival. No correlation was found between gender, age, location, or histological subtypes and survival. Bone involvement in NHL appears late in the extraskeletal disease. The clinical appearance is nonspecific, and the delay between the onset of symptoms and diagnosis is often long. One of the major radiologic signs is the existence of a soft-tissue tumor surrounding the bone with little or no bone involvement on plain films. Treatment generally is conservative, based on the stage of the disease. Local radiation with or without systemic chemotherapy should be used. The long-term survival is favorable, but dependent on the stage of the disease and the amount of bone involvement.

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Malignant lymphoma of bone

Dürr

Müller

Hiller

et al. 2001

Arch Orthop Trauma Surg

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Myeloablative Radioimmunotherapy with Re-188-anti-CD66-Antibody for Conditioning of High-Risk Leukemia Patients Prior to Stem Cell Transplantation: Biodistribution, Biokinetics and Immediate Toxicities

Buchmann

Bunjes

Kotzerke

et al. 2002

Cancer Biotherapy and Radiopharmaceuticals

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The Use of Monoclonal Antibodies for Radioscintigraphic Detection of Cancer

Harwood

Abdel-Nabi

1994

Journal of Pharmacy Practice

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Beginning with Ehrlich's original “magic bullet” concept of 1904, the pioneering human trials in the late 1970s of Goldenberg and Mach using polyclonal antibodies, and the Nobel Prize-winning work of Kohler and Milstein in 1975 for developing monoclonal antibody (MAb) technology, there has been much interest in the use of antibodies for detecting and treating cancer. Although not the revolutionary breakthrough that was initially hoped for, marked progress has been made. The Food and Drug Administration (FDA) has recently approved the intact murine IgG, 111-indium CYT-103 (satumomoab, Oncoscint™ Cytogen, Princeton, NJ) for clinical use in detecting colorectal and ovarian cancer. However, the agent has been approved for only a single, one-time use, because patients developed an immune response (human anti-mouse antibody, or HAMA) that alters MAb biodistribution and may limit the clinical effectiveness of this agent when repeat studies are performed. Other MAbs reacting with a variety of antigens and targeting numerous tumors, including breast, lung, prostate, and melanomas, are currently undergoing large-scale clinical trials. To reduce induction of immune responses, many of the agents use immunoglobulin fragments [Fab, or F(ab)2] labeled with the short-lived isotope 99m-technetium used for most routine nuclear medicine diagnostic testing. Future developments will use even smaller fragments such as single chain antibodies or custom synthesized molecular recognition units (small peptides containing only the specific antigen combining site). Presented herein is an overview of the past results and an assessment of the current status of radioimmunoscintigraphy for various neoplasms.

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Nachweis des Skelettbefalls maligner Erkrankungen durch Immunszintigraphie des Knochenmarks

Cited by 3 publications

References 20 publications

Malignant lymphoma of bone

Malignant lymphoma of bone

Myeloablative Radioimmunotherapy with Re-188-anti-CD66-Antibody for Conditioning of High-Risk Leukemia Patients Prior to Stem Cell Transplantation: Biodistribution, Biokinetics and Immediate Toxicities

The Use of Monoclonal Antibodies for Radioscintigraphic Detection of Cancer

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