title: Clinical outcomes of post-remission therapy using (90)yttrium ibritumomab tiuxetan (Zevalin®) for high-risk patients with diffuse large B-cell lymphoma.
abstract: This phase II trial evaluated the efficacy and safety of tandem consolidation using (90)yttrium ibritumomab tiuxetan ((90)Y-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 chemotherapy. Subsequently, the patients received one to two courses of ifosfamide-containing regimen for peripheral blood stem cell mobilization and harvesting. First consolidation with (90)Y-IT was performed, followed by second consolidation using HDT with PBSCT. All patients received (90)Y-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 (90)Y-IT consolidation were primarily transient hematologic toxicities. The present pilot study suggests that tandem consolidation therapy using (90)Y-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.
authors.affiliation: Department of Radiology, Catholic Lymphoma Study Group, The Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Han
authors.forename: Sung-Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Hyung Sun
authors.initials: HS
authors.lastname: Sohn
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Jung
authors.forename: Gyeongsin
authors.initials: G
authors.lastname: Park
authors.forename: Byung-Ock
authors.initials: BO
authors.lastname: Choi
authors.forename: Sang-Nam
authors.initials: SN
authors.lastname: Lee
authors.forename: Suk-Woo
authors.initials: SW
authors.lastname: Yang
authors.forename: Kyungja
authors.initials: K
authors.lastname: Han
authors.forename: Seok-Goo
authors.initials: SG
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000517:prevention & control* / Q000532:radiotherapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D016499:Radioimmunotherapy / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012074:Remission Induction; D012307:Risk Factors; D000069283:Rituximab; D055502:Secondary Prevention; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; C422802:ibritumomab tiuxetan; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone