Targeted Radiotherapy in HSCT for Poor Risk Haematological Malignancy

Inclusion Criteria:

1. An underlying haematological malignancy including acute myeloid leukaemia in first complete remission (CR1) but with poor prognostic features or in \>CR1 or in relapse; acute lymphoblastic leukaemia; transformed myelodysplasia, chronic myeloid leukaemia (accelerated phase or blast transformation, poor response or intolerance of tyrosine kinase inhibitors), myeloma. Patients may be in remission, partial remission or relapse.
2. No concurrent or recent (within 3 weeks) chemotherapy for the underlying haematological condition
3. For patients with relapsed leukaemia, bone marrow (BM) blasts must represent \< 20% of BM nucleated cells.
4. Although the BM remission status is not important, patients must have cellularity \> 10%.
5. As malignant plasma cells may or may not express CD66 antigens, patients with myeloma must have less than 30% plasma cells (as a percentage of total nucleated cells) in the BM at the time of the study.
6. Age = or \>18 yrs.
7. WHO performance status of 0, 1 or 2 (Appendix 5).
8. Predicted life-expectancy of greater than four months.
9. Patients must be negative for human anti-mouse antibodies (HAMA).
10. Peripheral blood counts:

    Wbc \< 30 x 10e9/l (absolute neutrophil count \>0.5 x 10e9/L) platelets \> 50 x 10e9/l (platelet support is permitted)
11. Biochemical indices:

    Plasma creatinine \< 120 micromol/l (or creatinine clearance or Ethylene diamine tetra acetic acid (EDTA) clearance \> 50 ml/min) Plasma bilirubin \< 30 micromol/l Aspartate aminotransferase (AST) or Alanine aminotransferase (ALT) no more than 2.5 x upper limit of the normal range.
12. Patient must be able to provide written informed consent.

Exclusion Criteria:

1. Any serious intercurrent disease.
2. Patients with BM cellularity \< 10%.
3. History of atopic asthma, eczema or allergy to rodent protein, confirmed history of severe allergic reactions to penicillin or streptomycin.
4. Positive Human anti-murine antibodies (HAMA).
5. Patients unable to provide informed consent or who are unable to co-operate for reasons of poor mental or physical health.
6. Pregnancy