{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T02:36:20Z","timestamp":1761100580358,"version":"build-2065373602"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2003,3,3]],"date-time":"2003-03-03T00:00:00Z","timestamp":1046649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2003,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Anti\u2010B4\u2010blocked ricin is an immunotoxin comprised of an anti\u2010CD19 murine monoclonal antibody (B4) conjugated to <jats:italic>blocked ricin<\/jats:italic>, which has cytotoxic activity in patients with lymphoid malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Adults with untreated acute lymphoblastic leukemia (ALL) were treated with a previously developed and tested chemotherapeutic regimen. Patients with CD19 positive ALL were given anti\u2010B4\u2010blocked ricin as 2 7\u2010day continuous infusions 1 week apart. Patients with CD19 negative ALL received high\u2010dose cytarabine. Serial polymerase chain reaction (PCR) assays of <jats:italic>BCR\u2010ABL<\/jats:italic>, immunoglobulin heavy chain (<jats:italic>IGH<\/jats:italic>), and T\u2010cell receptor (<jats:italic>TCR<\/jats:italic>) genes were used to measure the impact of lineage specific intensification treatment on minimal residual disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Eighty\u2010two adults were enrolled, and 78 were eligible. The median age was 34 years (range, 17\u201381 years). Sixty\u2010six patients (85%) achieved complete remission. Forty\u2010six patients received the anti\u2010B4\u2010blocked ricin, which generally was well tolerated; 80% were able to receive both courses. The most common toxicity was asymptomatic transient elevation of liver function tests in 72% of patients. Lymphopenia occurred in 46% of patients. Two patients developed antibodies to the anti\u2010B4\u2010blocked ricin. Molecular monitoring before and after the experimental course of intensification did not show a consistent change in the number of leukemia cells remaining, and the immediate posttreatment PCR studies did not correlate with remission duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Intensification therapy with anti\u2010B4\u2010blocked ricin is feasible for patients with CD19 positive ALL, although there is little evidence of an additional clinical benefit from the anti\u2010B4\u2010blocked ricin. Cancer 2003;97:1471\u201380. \u00a9 2003 American Cancer Society.<\/jats:p><jats:p>DOI 10.1002\/cncr.11219<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.11219","type":"journal-article","created":{"date-parts":[[2003,3,18]],"date-time":"2003-03-18T17:44:31Z","timestamp":1048009471000},"page":"1471-1480","source":"Crossref","is-referenced-by-count":48,"title":["Lineage specific treatment of adult patients with acute lymphoblastic leukemia in first remission with anti\u2010B4\u2010blocked ricin or high\u2010dose cytarabine"],"prefix":"10.1002","volume":"97","author":[{"given":"Ted P.","family":"Szatrowski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard K.","family":"Dodge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Reynolds","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol 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