Abstract
The antibody-drug conjugate (ADC) is a unique combination of potent cytotoxic drugs covalently linked to monoclonal antibodies (mAb) through a stable specialized chemical linker. Recombinant immunotoxins, fusion proteins which contain the cytotoxic portion of a protein toxin fused to the Fv portion of an antibody, represent the most promising group of ADCs. Antibody-drug conjugates maximize drug delivery to tumor cells without increasing toxicity to normal cells. There are a number of ADCs in preclinical and clinical developments in haematological malignancies that target CD19, CD22, CD25, CD30, CD33, CD37, CD74, and CD79b. One of them, brentuximab vedotin, is approved for use in Hodgkin’s lymphoma and systemic anaplastic large cell lymphoma. This chapter focuses on the use of mAbs or fragments of mAbs attached to cytotoxic agents produced by bacteria or plants, including high-molecular-weight protein toxins and low-molecular-weight chemical entities such as calicheamicin, mytansinoids or auristatin, in the treatment of acute myeloid leukemia, B- and T-cell lymphoid malignancies, Hodgkin lymphoma and multiple myeloma.
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