Clinical outcomes of post-remission therapy using (90)yttrium ibritumomab tiuxetan (Zevalin®) for high-risk patients with diffuse large B-cell lymphoma.

Abstract

This phase II trial evaluated the efficacy and safety of tandem consolidation using (90)yttrium ibritumomab tiuxetan ((90)Y-IT) and high-dose therapy (HDT) with autologous peripheral blood stem cell transplantation (PBSCT) in high-risk patients with diffuse large B-cell lymphoma (DLBCL) who were in primary remission. Eleven patients with high-risk DLBCL were enrolled. All patients had achieved complete or partial response after six to eight cycles of rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as a frontline chemotherapy. Subsequently, the patients received one to two courses of ifosfamide-containing regimen for peripheral blood stem cell mobilization and harvesting. First consolidation with (90)Y-IT was performed, followed by second consolidation using HDT with PBSCT. All patients received (90)Y-IT therapy, but three patients did not undergo PBSCT. During the median follow-up period of 18.1 months, 9 of 11 patients exhibited disease progression, and 8 patients died. The estimated 2-year progression-free survival was 18.2%, and overall survival was 36.4%. Adverse events following (90)Y-IT consolidation were primarily transient hematologic toxicities. The present pilot study suggests that tandem consolidation therapy using (90)Y-IT followed by HDT with autologous PBSCT is not feasible for treatment of high-risk patients with DLBCL in remission after R-CHOP. In addition, this treatment failed to provide beneficial effects for the clinical outcome of subsequent PBSCT.

• Authors: Eun Ji Han, Sung-Eun Lee, Sung Hoon Kim, Hyung Sun Sohn, Seung Eun Jung, Gyeongsin Park, Byung-Ock Choi, Sang-Nam Lee, Suk-Woo Yang, Kyungja Han, Seok-Goo Cho
• Journal: Annals of hematology (Ann Hematol) Vol. 90 Issue 9 Pg. 1075-82 (Sep 2011) ISSN: 1432-0584 [Electronic] Germany
• PMID: 21336624 (Publication Type: Clinical Trial, Phase II, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Rituximab
• ibritumomab tiuxetan
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adult
• Aged
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Murine-Derived (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Combined Modality Therapy
• Cyclophosphamide (administration & dosage, therapeutic use)
• Doxorubicin (administration & dosage, therapeutic use)
• Female
• Humans
• Lymphoma, Large B-Cell, Diffuse (prevention & control, radiotherapy, therapy)
• Male
• Middle Aged
• Peripheral Blood Stem Cell Transplantation (methods)
• Prednisone (administration & dosage, therapeutic use)
• Radioimmunotherapy (methods)
• Radiotherapy, Adjuvant (methods)
• Remission Induction
• Risk Factors
• Rituximab
• Secondary Prevention
• Transplantation, Autologous
• Treatment Outcome
• Vincristine (administration & dosage, therapeutic use)