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Ann Hematol (2011) 90:10751082 DOI 10.1007/s00277-011-1191-6
ORIGINAL ARTICLE
Clinical outcomes of post-remission therapy using 90yttrium ibritumomab tiuxetan (Zevalin) for high-risk patients with diffuse large B-cell lymphoma
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
Received: 7 July 2010 /Accepted: 7 February 2011 /Published online: 19 February 2011 # Springer-Verlag 2011
Abstract This phase II trial evaluated the efficacy and safety of tandem consolidation using 90yttrium ibritumomab tiuxetan (90Y-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 chemo-therapy. Subsequently, the patients received one to two courses of ifosfamide-containing regimen for peripheral blood stem cell mobilization and harvesting. First consolidation with 90Y-IT was performed, followed by second consolidation using HDT with PBSCT. All patients received 90Y-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 90Y-IT consolidation were primarily transient hematologic toxicities. The present pilot study suggests that tandem consolidation therapy using 90Y-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.
Keywords Diffuse large B-cell lymphoma . High-risk patients . Radioimmunotherapy. 90Yttrium ibritumomab tiuxetan . Post-remission therapy
Eun Ji Han and Sung-Eun Lee equally contributed in this study.
S.-E. Lee : S.-G. Cho (*)
Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Marys Hospital,The Catholic University of Korea College of Medicine, #505, Banpo-dong, Seocho-gu,Seoul, South Korea 137-040e-mail: [email protected]
E. J. Han : S. H. Kim : H. S. Sohn : S. E. JungDepartment of Radiology, Catholic Lymphoma Study Group (CULG), The Catholic University of Korea College...