(90)Y ibritumomab tiuxetan (Zevalin) combined with BEAM (Z -BEAM) conditioning regimen plus autologous stem cell transplantation in relapsed or refractory low-grade CD20-positive B-cell lymphoma. A GELA phase II prospective study.

Abstract

BACKGROUND:

This study was designed to evaluate the safety and efficacy of a conventional dose of yttrium-90 ((90)Y) ibritumomab tiuxetan combined with the etoposide rabinoside acytarabine melphalan (BEAM) regimen before autologous stem cell transplantation (ASCT) in chemosensitive relapsed or refractory low-grade B-cell lymphomas.

PATIENTS AND METHODS:

From March 2005 to August 2006, 77 prospective patients were included, 69 (90%) with follicular lymphomas.

RESULTS:

The last salvage chemotherapy regimen included rituximab for 74 patients and ASCT for 75 patients. Before ASCT, rates of complete response/unconfirmed response (CR/CRu) and partial response were 77% and 23%, respectively. After zevaline-BEAM (Z-BEAM), time to >1 × 10(9)/L neutrophils was 12 days (range, 9-35 days), and time to >20 × 10(9)/L platelets was 12 days (range, 3-42 days). No other significant extrahematologic toxicity was observed. Three months after ASCT, 68 patients (88%) were in CR/CRu. After a median follow-up of 28 months, 2-year event-free survival (EFS) and overall survival were 63% and 97%, respectively, but EFS for first-relapsed patients was 72%. When using patients as their own controls, 2-year EFS was superior after ASCT and compared favorably with the duration of response of last chemotherapy (62% vs. 37%, P = .007) (Point 1.10).

CONCLUSION:

Z-BEAM appears safe and needs to be further evaluated in a randomized trial.

• Authors: Didier Decaudin, Nicolas Mounier, Hervé Tilly, Vincent Ribrag, Hervé Ghesquières, Krimo Bouabdallah, Franck Morschhauser, Bertrand Coiffier, Steven Le Gouill, Serge Bologna, Richard Delarue, Anne Huynh, André Bosly, Josette Brière, Christian Gisselbrecht
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 11 Issue 2 Pg. 212-8 (Apr 2011) ISSN: 2152-2669 [Electronic] United States
• PMID: 21575926 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: 2011. Published by Elsevier Inc.

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Agents
• Cytarabine
• Rituximab
• Podophyllotoxin
• Melphalan
• Carmustine

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Monoclonal, Murine-Derived (adverse effects, therapeutic use)
• Antineoplastic Agents (adverse effects, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Carmustine (adverse effects, therapeutic use)
• Cytarabine (adverse effects, therapeutic use)
• Hematopoietic Stem Cell Transplantation
• Humans
• Lymphoma, B-Cell (pathology, therapy)
• Melphalan (adverse effects, therapeutic use)
• Middle Aged
• Neoplasm Staging
• Podophyllotoxin (adverse effects, therapeutic use)
• Rituximab
• Survival Analysis
• Transplantation, Autologous
• Treatment Outcome
• Young Adult