Human anti-murine immune response following administration of radiolabeled monoclonal antibodies

The author's purpose is to measure circulating anti-murine immunoglobulin antibodies (HAMA) in patients who previously received radiolabeled monoclonal antibodies (MoAb) for tumor imaging and therapy. Because the presence of HAMA may negate further use of MoAb in patients, it is important to determine the frequency and rate of HAMA development. Patients received radiolabeled MoAb Fab 96.5 (IgG2a), Fab 48.7 (IgG1), T101 (IgG2a), B72.3 (IgG1), 9.2.27 (IgG2a) and 791T/36 (IgG2b). HAMA was measured by incubating I-125 labeled 96.5, 48.7 or B72.3 with serum and isolating human IgG with Staphyloccocal protein A cells by centrifugation. The assays were capable of detecting HAMA concentrations which bound 20 ng/ml of monoclonal antibody. 12 of 37 patients who received IgG developed HAMA within 4 months of a single injection. For one patient this occurred as early as 1 week post injection. 2 of 18 patients who received Fab developed HAMA. One of these patients received multiple injections of MoAb. 2 of 3 patients who received IgG2B were positive for HAMA. There was no apparent difference in the positive HAMA when antibody or fragment was given SubQ or IV. The authors conclude that the use of IgG MoAb are more likely to lead to the development of antimurine immunoglobulin antibodies