radiolabeled monoclonal antibody in the detection and staging of patients with non-hodgkin's lymphoma

Conditions: Lymphoma

Summary: rationale: diagnostic imaging procedures using radiolabeled monoclonal antibodies may improve the ability to detect and stage non-hodgkin's lymphoma. purpose: phase iii trial to study the effectiveness of a radiolabeled monoclonal antibody in the detection and staging of patients with non-hodgkin's lymphoma.

objectives: i. determine the radioimmunodetection performance of the imaging agent technetium tc 99m ll2 monoclonal antibody (lymphoscan) in patients with low, intermediate, and high grade b-cell non-hodgkin's lymphoma. ii. define the safety of an initial administration of technetium tc 99m ll2 monoclonal antibody in these patients. iii. demonstrate that diagnostic imaging with this agent can correctly stage patients who have been diagnosed with this disease similarly to noninvasive conventional diagnostic modalities (cdms), primarily ct scan and bone scan. iv. demonstrate that imaging with technetium tc 99m ll2 monoclonal antibody is at least as sensitive for detecting disease in various body sites as any other standard diagnostic imaging method. v. compare patient management plans based on cdms alone, technetium tc 99m ll2 monoclonal antibody alone, and both cdms and technetium tc 99m ll2 monoclonal antibody. vi. describe the human antimouse antibody production in these patients. outline: this is an open label, multicenter study. after all other diagnostic studies have been completed, patients receive an infusion of technetium tc 99m ll2 monoclonal antibody by iv injection or infused over 20-30 minutes as part of their staging procedures. planar images are acquired between 4-8 hours and 18-24 hours following antibody injection, and single photon emission computerized tomography (spect) imaging is performed between 4-8 hours following antibody injection. patients may receive a repeat injection of technetium tc 99m ll2 monoclonal antibody. patients are followed for 3 to 6 months. projected accrual: at least 100 patients will be accrued into this study.

Eligibility criteria:
disease characteristics: histologically confirmed b-cell non-hodgkin's lymphoma (low, intermediate, or high grade categories) a new classification scheme for adult non-hodgkin's lymphoma has been adopted by pdq. the terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. however, this protocol uses the former terminology. patient characteristics: age: 16 and over performance status: ecog 0-2 life expectancy: not specified hematopoietic: not specified hepatic: not specified renal: bun no greater than 1.5 times upper limit of normal (uln) creatinine no greater than 1.5 times uln other: no known allergies to mouse proteins no second primary malignancy within past 5 years other than adequately treated in situ carcinoma of the cervix or uterus, or basal or squamous cell carcinoma of the skin not pregnant or nursing effective contraception required of all fertile patients prior concurrent therapy: biologic therapy: no prior exposure to mouse antibodies other than technetium tc 99m ll2 monoclonal antibody chemotherapy: not specified endocrine therapy: not specified radiotherapy: not specified surgery: not specified other: at least 1 month since any other prior investigational therapy no concurrent participation in another protocol involving medical devices or investigational agents

Keywords: stage i grade 1 follicular lymphoma stage i grade 2 follicular lymphoma stage i grade 3 follicular lymphoma stage i adult diffuse small cleaved cell lymphoma stage i adult diffuse mixed cell lymphoma stage i adult diffuse large cell lymphoma stage i adult immunoblastic large cell lymphoma stage i adult lymphoblastic lymphoma stage i adult burkitt lymphoma stage iii grade 1 follicular lymphoma stage iii grade 2 follicular lymphoma stage iii grade 3 follicular lymphoma stage iii adult diffuse small cleaved cell lymphoma stage iii adult diffuse mixed cell lymphoma stage iii adult diffuse large cell lymphoma stage iii adult immunoblastic large cell lymphoma stage iii adult lymphoblastic lymphoma stage iii adult burkitt lymphoma stage iv grade 1 follicular lymphoma stage iv grade 2 follicular lymphoma stage iv grade 3 follicular lymphoma stage iv adult diffuse small cleaved cell lymphoma stage iv adult diffuse mixed cell lymphoma stage iv adult diffuse large cell lymphoma stage iv adult immunoblastic large cell lymphoma stage iv adult lymphoblastic lymphoma stage iv adult burkitt lymphoma recurrent grade 1 follicular lymphoma recurrent grade 2 follicular lymphoma recurrent grade 3 follicular lymphoma recurrent adult diffuse small cleaved cell lymphoma recurrent adult diffuse mixed cell lymphoma recurrent adult diffuse large cell lymphoma recurrent adult immunoblastic large cell lymphoma recurrent adult lymphoblastic lymphoma recurrent adult burkitt lymphoma stage i mantle cell lymphoma contiguous stage ii grade 1 follicular lymphoma contiguous stage ii grade 2 follicular lymphoma contiguous stage ii grade 3 follicular lymphoma contiguous stage ii adult diffuse small cleaved cell lymphoma contiguous stage ii mantle cell lymphoma contiguous stage ii adult diffuse mixed cell lymphoma contiguous stage ii adult immunoblastic large cell lymphoma contiguous stage ii adult diffuse large cell lymphoma contiguous stage ii adult burkitt lymphoma contiguous stage ii adult lymphoblastic lymphoma noncontiguous stage ii grade 1 follicular lymphoma noncontiguous stage ii grade 2 follicular lymphoma noncontiguous stage ii grade 3 follicular lymphoma noncontiguous stage ii adult diffuse small cleaved cell lymphoma noncontiguous stage ii mantle cell lymphoma noncontiguous stage ii adult diffuse mixed cell lymphoma noncontiguous stage ii adult immunoblastic large cell lymphoma noncontiguous stage ii adult diffuse large cell lymphoma noncontiguous stage ii adult burkitt lymphoma noncontiguous stage ii adult lymphoblastic lymphoma stage iii mantle cell lymphoma stage iv mantle cell lymphoma recurrent mantle cell lymphoma noncontiguous stage ii small lymphocytic lymphoma noncontiguous stage ii marginal zone lymphoma recurrent marginal zone lymphoma recurrent small lymphocytic lymphoma stage i marginal zone lymphoma stage i small lymphocytic lymphoma stage iii small lymphocytic lymphoma stage iii marginal zone lymphoma stage iv small lymphocytic lymphoma stage iv marginal zone lymphoma contiguous stage ii marginal zone lymphoma contiguous stage ii small lymphocytic lymphoma extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue nodal marginal zone b-cell lymphoma splenic marginal zone lymphoma