scholarly journals Yttrium-90 ibritumomab tiuxetan consolidation versus rituximab maintenance therapy after induction chemotherapy in patients with indolent non-Hodgkin lymphoma: a single-institution experience

Hematology ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 623-630 ◽  
Author(s):  
Masaki Iino ◽  
Yuma Sakamoto ◽  
Tomoya Sato
Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3703-3703
Author(s):  
Jae-Cheol Jo ◽  
Dok Hyun Yoon ◽  
Shin Kim ◽  
Seongsoo Jang ◽  
Chan-Jeoung Park ◽  
...  

Abstract Abstract 3703 Background: Currently, there are accumulating data on the role of radioimmunotherapy in autologous stem cell transplantation (ASCT) with promising results. We compared the efficacy and safety of yttrium-90-ibritumomab tiuxetan (90Y-ibritumomab) combined with intravenous busulfan, cyclophosphamide, and etoposide (BuCyE) with those of BuCyE alone followed by ASCT in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (NHL). Patients and Methods: From October 2005 to May 2011, 71 NHL patients underwent high-dose chemotherapy with BuCyE (n=52) or 90Y-ibritumomab plus BuCyE (n=19) followed by ASCT at the Asan Medical Center. Of 52 patients receiving BuCyE, we found 19 patients who had B-cell NHL and they comprised control group of BuCyE alone (n=19). Retrospective comparison matched by the same IPI was performed for the efficacy and safety between two groups. Results: The patient cohort consisted of 38 individuals (19 males), of median age 52 years (range, 27–65 years). The baseline characteristics were well balanced between the two groups. The median time to platelet engraftment (>20,000/mm3) and the median time to neutrophil engraftment (>500/mm3) did not differ between 90Y-ibritumomab plus BuCyE (12 days [range, 3–103 days] and 10 days [range, 8–12 days], respectively) and BuCyE alone (12 days [range, 8–35 days] and 10 days [range, 9–12 days], respectively). The objective overall response rate was 89.5% (17/19): continued CR, 42.1% (8/19); induced CR, 36.8% (7/19); PR, 10.5% (2/19) in 90Y-ibritumomab plus BuCyE group, and 78.9% (15/19): continued CR, 26.3% (5/19); induced CR, 47.4% (9/19); PR, 5.3% (1/19) in BuCyE group, respectively (p =0.649). Median follow-up duration for survivors was 30 months. Event-free survival tended to be better in 90Y-ibritumomab plus BuCyE group with a median event-free survival duration of 12.5 months in 90Y-ibritumomab plus BuCyE group and 6.2 months in BuCyE group (p =0.236) (figure 1-a).There seemed to be no significant difference in overall survival between the two groups (p =0.767, figure 1-b). The toxicities including the incidence of grade 3 or higher stomatitis, nausea, vomiting, diarrhea, hyperbilirubinemia were similar in the two groups. Conclusion: Addition of 90Y-ibritumomab to BuCyE high-dose chemotherapy may potentially benefit patients with relapsed or refractory B-cell NHL at no cost of additional toxicity, which warrants further investigation. Disclosures: No relevant conflicts of interest to declare.


2007 ◽  
Vol 7 (8) ◽  
pp. 514-517 ◽  
Author(s):  
Gregory A. Wiseman ◽  
Peter S. Conti ◽  
Katie Vo ◽  
Russell J. Schilder ◽  
Leo I. Gordon ◽  
...  

Cancer ◽  
2007 ◽  
Vol 109 (9) ◽  
pp. 1804-1810 ◽  
Author(s):  
Thomas E. Witzig ◽  
Arturo Molina ◽  
Leo I. Gordon ◽  
Christos Emmanouilides ◽  
Russell J. Schilder ◽  
...  

Cancer ◽  
2008 ◽  
Vol 112 (4) ◽  
pp. 856-862 ◽  
Author(s):  
Pier Luigi Zinzani ◽  
Monica Tani ◽  
Stefano Fanti ◽  
Vittorio Stefoni ◽  
Gerardo Musuraca ◽  
...  

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4699-4699
Author(s):  
Peter Martin ◽  
Rene Michel ◽  
Ahmed Galal

Abstract Background: Radioimmunotherapy (RIT) is an effective treatment of Non-Hodgkin Lymphoma (NHL). Nonetheless, the use of RIT outside of clinical trials has been limited. We report here the experience in 25 patients treated with Y-90 ibritumomab tiuxetan off-protocol at a single institution. Patients and Methods: The charts of all patients treated with RIT between October, 2004 and May, 2006 were retrospectively reviewed in accordance with Good Clinical Practice guidelines. 19 patients were treated with RIT alone while 6 were treated with RIT in combination with high-dose chemotherapy and autologous hematopoietic stem cell transplant (HSCT). Dosimetry was not performed. Results: The median age of patients was 56 years (range 43–71 years). 13 of 25 had high-grade lymphoma (either transformed lymphoma or diffuse large B-cell lymphoma). The median IPI was 3. The median number of prior regimens was 3 (range 1–6). 6 patients had received fludarabine. 3 patients had undergone prior autologous HSCT and one had undergone allogeneic HSCT. The median time to platelet recovery >20 × 109/L was 35 days. One patient continues to have platelets <20 × 109/L 380 days post-RIT. The median time to recover platelets to >20 × 109/L was 72 among patients who had previously received fludarabine. Prior HSCT also appeared to be associated with prolonged thrombocytopenia. 7 patients remained neutropenic (ANC<0.5 × 109/L) for >30 days. One patient who had been treated with 4 lines of prior chemotherapy, including prolonged chlorambucil, developed acute myeloid leukemia at 6 months post-RIT. There have been 3 deaths to date, all due to disease progression at 1, 1, and 3 months post-RIT. The overall response rate in 21 of 25 patients was 84% with 9 patients achieving CR. With a median follow-up of 7 months, 5 patients have progressed. Conclusion: The use of off-protocol RIT in our institution was associated with similar response rates to those reported in patients treated on-protocol. Off concern, however, is the significant hematologic toxicity. There was an association between prior fludarabine and prolonged thrombocytopenia that has not been reported previously.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4795-4795
Author(s):  
Silvana Capalbo ◽  
Gaetano Palumbo ◽  
Matteo Dell'Olio ◽  
Maria Grazia Franzese ◽  
Attilio Guarini ◽  
...  

Abstract Abstract 4795 Introduction Radioimmunotherapy (RIT) has emerged as an important treatment options for patients with non-Hodgkin lymphoma (NHL). Yttrium-90 ibritumomab tiuxetan (Zevalin®) consist of ibritumomab, a murine monoclonal antibody to CD20, conjugated to the metal chelator tiuxetan for retention of the beta emitter Yttrium-90. Clinical trials with this agent have demonstrated significant activity in indolent NHL with mild toxicity. The median age of NHL patients included in these trials is mainly < 65 years. Our aim was to evaluate the effectiveness of Zevalin as treatment option for patient > 65 years old with indolent NHL. Patients and Methods Between November 2005 to June 2009 fifteen patients, five males and ten females, median age 76 years (range 67-82), with indolent NHL (13 follicular and 2 small lymphocytic) were treated with Zevalin. Six patients had stage IV disease, five stage III and four stage II. All patients received an initial infusion of rituximab at a dose of 250 mg/m(e)2 on day 1 and a second infusion at same dose on day 8 followed by a weight-based dose of Zevalin (median dose 1006 MBq; range 668-1260). Eight patients perfomed Zevalin as consolidation after first line therapy with Rituximab plus chemotherapy (6 R-CHOP, 1 R-FN, 1 R-COMP): of these three were in complete remission (CR) and five in partial remission (PR). Seven patients perfomed Zevalin in relapse (four in first and three in second relapse). Results After RIT 13 of 15 patients were evaluable. Overall response rate was 92% (10 CR, 2 PR); in particular all patients in first line of treatment achieved CR. One patient had stable disease. At a median follow-up of 15 months (range 2-34), all patients are alive in persistent CR or PR. One of two patients in PR achieved CR after successive therapy. Treatment was well tolerated; transient thrombocytopenia (grade 3-4) was seen in 9 patients and transient neutropenia (grade 3-4 ) in 6 patients. Only one patient developed herpex-zoster virus infection. Conclusion In our experience, Zevalin produces high response rate (up to 90%) and durable remission without severe toxicity in older patients with indolent NHL. Notably, in first-line treatment, RIT resulted in PR-to-CR conversion in all five patients in PR after the R-chemotherapy. The favourable safety profile of this regimen makes it an effective consolidation treatment for older patients who, because of age and comorbidity, are not eligible for intensive treatment as high-dose therapy and stem cell transplantation. Disclosures: No relevant conflicts of interest to declare.


Sign in / Sign up

Export Citation Format

Share Document