Introduction. The addition of antibody monoclonal anti CD20 Rituximab to CHOP chemotherapy has resulted in improved CR, progression free survival and overall survival rates for patients affected by follicular lymphoma. Recently, a phase II trial has showed that Zevalin has a useful activity in the treatment of relapsed refractory elderly DLBCL. We report the results of a study to evaluate the clinical utility and safety of Zevalin in relapsed or chemoresistant aggressive lymphoma. Patients and Methods. patient elegibility was represented by: age over 18 yrs, refractory or chemoresistant aggressive lymphoma (grade III follicular, PML or DLBCL de novo), CD20 positivity, WHO performance status of 0 to 2, stage II bulky, III or IV, bone marrow involvement < 25%. All patients were previously treated with almost two lines of chemotherapy and all of them received Rituximab. All patients signed a written informed consent approved in accordance with institutional guidelines. Patients with pre-treatment platelet counts of >150.000/mm3 received Zevalin at 0.4 mCi/kg whereas those with platelets <150.000/mm3 received 0.3 mCi/kg. Results. a total of 14 patients were treated: 5 patients were stage II, 3 stage III, 6 stage IV (5 with bone marrow involvement). Six patients had grade III follicular, 4 primary mediastinal and 4 DLBCL de novo. Ten patients received 0.4 mCi/kg and 4 patients 0.3 mCi/kg. Five chemoresistant patients after 2 or more lines chemoimmunotherapy received RIT in combination with BEAM and subsequent autologous stem cell transplantation (ASCT) and 9 patients were treated with Zevalin alone. Response evaluation was performed two months after RIT. After 90YIbritumomab Tiuxetan infusion we reported CR 4 patients, PR 5 patients and no response/progression 5 patients (ORR 9/14 patients 64%). All 5 patients treated with RIT + BEAM + ASCT achieved a response (CR 2 patients and PR 3 patients ORR 100%). ORR in 9 patients treated with RIT alone was 46% (CR 2 patients and PR 2 patients). No toxic deaths were observed, one patients died of progressive lymphoma 1 year after Zevalin infusion. The most common grade 3-4 AE were neutropenia and thrombocytopenia. Discussion: RIT with 90Y-Ibritumomab Tiuxetan seems to be a safe and effective approach for heavily Rituximab + chemo pretreated aggressive lymphoma. Larger studies are needed to estabilish the effective role of RIT alone or in combination with high dose chemotherapy + ASCT as salvage therapy.
Efficacy of radioimmunotherapy (RIT) with Y-90-ibritumomab tiuxetan (zevalin) for the treatment of relapsed or resistant aggressive lymphoma heavily pretreated with rituximab plus chemotherapy / B., Botto; M., Bellò; G., Benevolo; M. G., Cabras; C., Castellino; A., Chiappella; G., Fioritoni; R., Freilone; Martelli, Maurizio; L., Orsucci; P., Pregno; P., Scapoli; A., Tonso; G., Bisi; U., Vitolo; E., Gallo. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 92 (SUPPL. 3):(2007), pp. 64-65. (Intervento presentato al convegno 41st Congress of the Italian-Society-of-Hematology tenutosi a Bologna, ITALY nel OCT 14-17, 2007).
Efficacy of radioimmunotherapy (RIT) with Y-90-ibritumomab tiuxetan (zevalin) for the treatment of relapsed or resistant aggressive lymphoma heavily pretreated with rituximab plus chemotherapy
MARTELLI, Maurizio;
2007
Abstract
Introduction. The addition of antibody monoclonal anti CD20 Rituximab to CHOP chemotherapy has resulted in improved CR, progression free survival and overall survival rates for patients affected by follicular lymphoma. Recently, a phase II trial has showed that Zevalin has a useful activity in the treatment of relapsed refractory elderly DLBCL. We report the results of a study to evaluate the clinical utility and safety of Zevalin in relapsed or chemoresistant aggressive lymphoma. Patients and Methods. patient elegibility was represented by: age over 18 yrs, refractory or chemoresistant aggressive lymphoma (grade III follicular, PML or DLBCL de novo), CD20 positivity, WHO performance status of 0 to 2, stage II bulky, III or IV, bone marrow involvement < 25%. All patients were previously treated with almost two lines of chemotherapy and all of them received Rituximab. All patients signed a written informed consent approved in accordance with institutional guidelines. Patients with pre-treatment platelet counts of >150.000/mm3 received Zevalin at 0.4 mCi/kg whereas those with platelets <150.000/mm3 received 0.3 mCi/kg. Results. a total of 14 patients were treated: 5 patients were stage II, 3 stage III, 6 stage IV (5 with bone marrow involvement). Six patients had grade III follicular, 4 primary mediastinal and 4 DLBCL de novo. Ten patients received 0.4 mCi/kg and 4 patients 0.3 mCi/kg. Five chemoresistant patients after 2 or more lines chemoimmunotherapy received RIT in combination with BEAM and subsequent autologous stem cell transplantation (ASCT) and 9 patients were treated with Zevalin alone. Response evaluation was performed two months after RIT. After 90YIbritumomab Tiuxetan infusion we reported CR 4 patients, PR 5 patients and no response/progression 5 patients (ORR 9/14 patients 64%). All 5 patients treated with RIT + BEAM + ASCT achieved a response (CR 2 patients and PR 3 patients ORR 100%). ORR in 9 patients treated with RIT alone was 46% (CR 2 patients and PR 2 patients). No toxic deaths were observed, one patients died of progressive lymphoma 1 year after Zevalin infusion. The most common grade 3-4 AE were neutropenia and thrombocytopenia. Discussion: RIT with 90Y-Ibritumomab Tiuxetan seems to be a safe and effective approach for heavily Rituximab + chemo pretreated aggressive lymphoma. Larger studies are needed to estabilish the effective role of RIT alone or in combination with high dose chemotherapy + ASCT as salvage therapy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
