Possibility of cancer-stem-cell-targeted radioimmunotherapy for acute myelogenous leukemia using (211)At-CXCR4 monoclonal antibody

To explore stem-cell-targeted radioimmunotherapy with α-particles in acute myelogenous leukemia (AML), pharmacokinetics and dosimetry of the (211)At-labeled anti-C-X-C chemokine receptor type 4 monoclonal antibody ((211)At-CXCR4 mAb) were conducted using tumor xenografted mice. The biological half-life of (211)At-CXCR4 mAb in blood was 15.0 h. The highest tumor uptake of 5.05%ID/g with the highest tumor-to-muscle ratio of 8.51 ± 6.14 was obtained at 6 h. Radiation dosimetry estimated with a human phantom showed absorbed doses of 0.512 mGy/MBq in the bone marrow, 0.287 mGy/MBq in the kidney, and <1 mGy/MBq in other major organs except bone. Sphere model analysis revealed 22.8 mGy/MBq in a tumor of 10 g; in this case, the tumor-to-bone marrow and tumor-to-kidney ratios were 44.5 and 79.4, respectively. The stem-cell-targeted α-particle therapy using (211)At-CXCR4 mAb for AML appears possible and requires further therapeutic studies.