title: Phase II trial of a transplantation regimen of yttrium-90 ibritumomab tiuxetan and high-dose chemotherapy in patients with non-Hodgkin's lymphoma.
abstract: OBJECTIVE
  This phase II trial evaluated the safety and efficacy of combining yttrium-90 (90Y) ibritumomab tiuxetan with high-dose carmustine, cytarabine, etoposide, and melphalan (BEAM) and autologous stem-cell transplantation in patients with non-Hodgkin's lymphoma who were considered ineligible for total-body irradiation because of older age or prior radiotherapy.
  
  
  METHODS
  Between May 2002 and January 2006, 14 days before autologous stem-cell transplantation, 41 patients with non-Hodgkin's lymphoma received standard-dose 90Y ibritumomab tiuxetan (14.8 MBq/kg [0.4 mCi/kg]) followed by high-dose BEAM.
  
  
  RESULTS
  The median age was 60 years (range, 19 to 78 years), and the median number of previous therapies was two (range, one to six). Disease histologies were diffuse large B-cell (n = 20), mantle cell (n = 13), follicular (n = 4), and transformed lymphoma (n = 4). With a median follow-up of 18.4 months (range, 5.5 to 53.3 months) the estimated 2-year overall and progression-free survival were 88.9% (95% CI, 75.3% to 95.2%) and 69.8% (95% CI, 56.4% to 79.7%). The median time to WBC engraftment was 11 days (range, 9 to 26 days) and time to platelet engraftment was 12 days (range, 3 to 107 days). Adverse events were similar to those seen historically with high-dose BEAM alone, and included grade 3 or 4 pulmonary toxicity in 10 patients.
  
  
  CONCLUSIONS
  Adding 90Y ibritumomab tiuxetan to high-dose BEAM with autologous stem-cell transplantation is feasible and has a toxicity and tolerability profile similar to that observed with BEAM alone. Rates of progression-free survival seen in these patients are promising and warrant additional study.
authors.affiliation: Division of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA. akrishnan@coh.org
authors.forename: Amrita
authors.initials: A
authors.lastname: Krishnan
authors.forename: Auayporn
authors.initials: A
authors.lastname: Nademanee
authors.forename: Henry C
authors.initials: HC
authors.lastname: Fung
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Raubitschek
authors.forename: Arturo
authors.initials: A
authors.lastname: Molina
authors.forename: Dave
authors.initials: D
authors.lastname: Yamauchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodriguez
authors.forename: Ricardo T
authors.initials: RT
authors.lastname: Spielberger
authors.forename: Peter
authors.initials: P
authors.lastname: Falk
authors.forename: Joycelynne M
authors.initials: JM
authors.lastname: Palmer
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forman
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000473:pathology / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000628:therapy; D020522:Lymphoma, Mantle-Cell / Q000473:pathology / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D011034:Podophyllotoxin / Q000627:therapeutic use; D016499:Radioimmunotherapy; D033581:Stem Cell Transplantation; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D015021:Yttrium Radioisotopes; D003561:Cytarabine; C422802:ibritumomab tiuxetan; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine