title: (90)Y ibritumomab tiuxetan (Zevalin) combined with BEAM (Z -BEAM) conditioning regimen plus autologous stem cell transplantation in relapsed or refractory low-grade CD20-positive B-cell lymphoma. A GELA phase II prospective study.
abstract: BACKGROUND
  This study was designed to evaluate the safety and efficacy of a conventional dose of yttrium-90 ((90)Y) ibritumomab tiuxetan combined with the etoposide rabinoside acytarabine melphalan (BEAM) regimen before autologous stem cell transplantation (ASCT) in chemosensitive relapsed or refractory low-grade B-cell lymphomas.
  
  
  METHODS
  From March 2005 to August 2006, 77 prospective patients were included, 69 (90%) with follicular lymphomas.
  
  
  RESULTS
  The last salvage chemotherapy regimen included rituximab for 74 patients and ASCT for 75 patients. Before ASCT, rates of complete response/unconfirmed response (CR/CRu) and partial response were 77% and 23%, respectively. After zevaline-BEAM (Z-BEAM), time to >1 × 10(9)/L neutrophils was 12 days (range, 9-35 days), and time to >20 × 10(9)/L platelets was 12 days (range, 3-42 days). No other significant extrahematologic toxicity was observed. Three months after ASCT, 68 patients (88%) were in CR/CRu. After a median follow-up of 28 months, 2-year event-free survival (EFS) and overall survival were 63% and 97%, respectively, but EFS for first-relapsed patients was 72%. When using patients as their own controls, 2-year EFS was superior after ASCT and compared favorably with the duration of response of last chemotherapy (62% vs. 37%, P = .007) (Point 1.10).
  
  
  CONCLUSIONS
  Z-BEAM appears safe and needs to be further evaluated in a randomized trial.
authors.affiliation: Department of Clinical Hematology / Preclinical Investigation Laboratory, Institut Curie, Paris, France. didier.decaudin@curie.net
authors.forename: Didier
authors.initials: D
authors.lastname: Decaudin
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mounier
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Vincent
authors.initials: V
authors.lastname: Ribrag
authors.forename: Hervé
authors.initials: H
authors.lastname: Ghesquières
authors.forename: Krimo
authors.initials: K
authors.lastname: Bouabdallah
authors.forename: Franck
authors.initials: F
authors.lastname: Morschhauser
authors.forename: Bertrand
authors.initials: B
authors.lastname: Coiffier
authors.forename: Steven
authors.initials: S
authors.lastname: Le Gouill
authors.forename: Serge
authors.initials: S
authors.lastname: Bologna
authors.forename: Richard
authors.initials: R
authors.lastname: Delarue
authors.forename: Anne
authors.initials: A
authors.lastname: Huynh
authors.forename: André
authors.initials: A
authors.lastname: Bosly
authors.forename: Josette
authors.initials: J
authors.lastname: Brière
authors.forename: Christian
authors.initials: C
authors.lastname: Gisselbrecht
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002330:Carmustine / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000009:adverse effects / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016393:Lymphoma, B-Cell / Q000473:pathology* / Q000628:therapy*; D008558:Melphalan / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D011034:Podophyllotoxin / Q000009:adverse effects / Q000627:therapeutic use; D000069283:Rituximab; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D003561:Cytarabine; D000069283:Rituximab; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine