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131I-apamistamab (Iomab-B) is a radioimmunotherapy consisting of the anti-CD45 monoclonal antibody apamistamab conjugated to the beta-emitting radioisotope iodine-131. Developed by Actinium Pharmaceuticals using its Antibody Warhead Enabling (AWE) Technology platform, it targets CD45, an antigen expressed on nearly all hematopoietic cells, including leukemia cells and hematopoietic stem cells. Its primary clinical application is as a targeted conditioning agent prior to hematopoietic stem cell transplantation (HSCT). By delivering localized radiation directly to the bone marrow and malignant cells, it aims to achieve effective lymphodepletion and myeloablation while minimizing the systemic toxicity typically associated with high-dose chemotherapy or total body irradiation. It is primarily being investigated for relapsed or refractory acute myeloid leukemia (AML) and is also being explored for other hematologic malignancies and non-malignant conditions such as sickle cell disease.
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