Radioimmunotherapy as a targeted strategy of reduced-intensity conditioning for allogeneic transplantation in leukemia

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Reduced-intensity conditioning (RIC) enhances allogeneic hematopoietic transplant (allo-HCT) efficacy for hematological cancers like acute myeloid leukemia (AML).
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Radioimmunotherapy (RIT) improves RIC by delivering targeted radiation to leukemia sites while minimizing damage to nonhematopoietic organs.
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CD45 is the primary target for RIT, effectively delivering radiation to 85%-90% of AML cells with minimal impact on nonhematopoietic tissues.
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Clinical trials show RIT combined with fludarabine-based RIC regimens is feasible, with hepatic toxicity being the main limitation.
5

Emerging strategies include α-emitters for localized radiation delivery, potentially enhancing graft-versus-leukemia effects without increasing graft-versus-host disease risk.

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