Safety and efficacy of yttrium-90 ibritumomab tiuxetan in older patients with non-Hodgkin's lymphoma.
OBJECTIVE
Treatment-related complications are more common in older patients with non-Hodgkin's lymphoma (NHL), often leading to chemotherapy modifications that can compromise efficacy. We analyzed data from clinical trials of yttrium-90-ibritumomab tiuxetan (Zevalin); Biogen Idec, Cambridge, MA) to determine its safety and efficacy in older patients with NHL.


METHODS
Data on safety and efficacy from four clinical trials of (90)Y-ibritumomab tiuxetan in 211 patients with NHL were pooled and analyzed by ages of <60, 60-69, and > or =70 years.


RESULTS
Patients > or =70 years had a similar incidence of grade 3 or 4 neutropenia (68% vs. 66%), thrombocytopenia (68% vs. 70%), anemia (8% vs. 22%), and nonhematologic adverse events (23% vs. 19%) as that observed in patients <60 years. Response rates (range, 71%-80%) and the durations of response (median of 9.9, 11.0, and 9.4 months) were similar in the three groups.


CONCLUSIONS
Yttrium-90-ibritumomab tiuxetan produces high rates of clinical response (up to 80%) and durable remissions in patients with NHL, and can be given at standard doses in older patients. The favorable safety profile of the regimen makes it an effective treatment for older patients, who may not otherwise tolerate the adverse events associated with chemotherapy.
Emmanouilides
Christos
C
Division of Hematology/Oncology, University of California, Los Angeles, CA, USA. chrem@interbalkan-hosp.gr
Witzig
Thomas E
TE
Wiseman
Gregory A
GA
Gordon
Leo I
LI
Wang
Hua
H
Schilder
Russell
R
Saville
M Wayne
MW
Flinn
Ian
I
Molina
Arturo
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005260:Female; D006402:Hematologic Diseases / Q000209:etiology; D006801:Humans; D000922:Immunotoxins / Q000009:adverse effects / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D016499:Radioimmunotherapy / Q000009:adverse effects; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000922:Immunotoxins; C422802:ibritumomab tiuxetan