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211At-NCS-BC8 is a radioimmunotherapeutic candidate consisting of the murine monoclonal antibody BC8, which targets the CD45 antigen (leukocyte common antigen), conjugated to the alpha-emitting radioisotope astatine-211 (211At). The conjugation is achieved using a boron cage linker, isothiocyanatophenethyl-ureido-closo-decaborate(2-) (B10-NCS), which provides high stability for the astatine label. CD45 is expressed on nearly all hematologic cells, including leukemia blasts, making it an ideal target for conditioning regimens prior to hematopoietic cell transplantation (HCT). Unlike beta-emitters such as Iodine-131, the alpha particles emitted by 211At have a high linear energy transfer and a short path length (50-100 µm), allowing for potent, localized cell killing with minimal damage to surrounding healthy tissues. Developed by researchers at the Fred Hutchinson Cancer Center and the University of Washington, 211At-NCS-BC8 is being evaluated in clinical trials to improve outcomes for patients with relapsed or refractory acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome (MDS) undergoing allogeneic HCT.
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