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211At-10C4-B10 is an experimental alpha-emitting radioimmunotherapy (RIT) targeting CD123 (interleukin-3 receptor alpha chain). It consists of a murine monoclonal antibody (clone 10C4) conjugated to a boron cage molecule, isothiocyanatophenethyl-ureido-closo-decaborate(2-) (B10), which is subsequently labeled with the alpha-particle emitting radionuclide astatine-211 (211At). CD123 is highly expressed on leukemic blasts and leukemic stem cells in acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome (MDS), while having limited expression on normal hematopoietic cells. The high linear energy transfer (LET) of alpha particles from 211At allows for potent, localized cell killing with minimal bystander toxicity. Preclinical studies have demonstrated significant anti-leukemia efficacy and prolonged survival in human leukemia xenograft models, supporting its potential use as a conditioning therapy before hematopoietic cell transplantation or as a stand-alone treatment.
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