Current status and future perspectives for yttrium-90 ((90)Y)-ibritumomab tiuxetan in stem cell transplantation for non-Hodgkin's lymphoma.
Haematopoietic SCT is currently considered a therapeutic option mainly in relapsed or refractory non-Hodgkin's lymphoma (NHL) owing to high post-transplantation relapse rates and significant toxicity of conventional myeloablative conditioning for allogeneic SCT. Radiolabelled immunotherapy combines the benefits of monoclonal antibody targeting with therapeutic doses of radiation, and is a promising advance in the treatment of malignant lymphomas. It is now under investigation as a component of conditioning prior to SCT, with the aim of improving outcomes following SCT without increasing the toxicity of high-dose chemotherapy pre-transplant conditioning. An expert panel met at a European workshop in November 2006 to review the latest data on radiolabelled immunotherapy in the transplant setting, and its potential future directions, with a focus on (90)Y-ibritumomab tiuxetan. They reviewed data on the combination of standard/high/escalating dose (90)Y-ibritumomab tiuxetan with high-dose chemotherapy, and high/escalating dose (90)Y-ibritumomab tiuxetan as the sole myeloablative agent, prior to autologous SCT, and also (90)Y-ibritumomab tiuxetan as a component of reduced intensity conditioning prior to allogeneic SCT. The preliminary data are highly promising in terms of conditioning tolerability and patient outcomes following transplant; further phase II studies are now needed to consolidate these data and to investigate specific patient populations and NHL subtypes.
Gisselbrecht
C
C
Institut d'Hématologie, Hôpital Saint-Louis, Paris, France. christian.gisselbrecht@sls.ap-hop-paris.fr
Bethge
W
W
Duarte
R F
RF
Gianni
A M
AM
Glass
B
B
Haioun
C
C
Martinelli
G
G
Nagler
A
A
Pettengell
R
R
Sureda
A
A
Tilly
H
H
Wilson
K
K
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D019653:Myeloablative Agonists; C422802:ibritumomab tiuxetan