title: Phase II study of first-line (131)I-rituximab radioimmunotherapy in follicular non-Hodgkin lymphoma and prognostic (18)F-fluorodeoxyglucose positron emission tomography.
abstract: First-line (131)I-anti-CD20 radioimmunotherapy of indolent non-Hodgkin lymphoma (NHL) achieves durable remission with low toxicity. The phase II INITIAL study comprised 68 patients with follicular NHL followed up to 7 years (median 4 years) after outpatient (131)I-rituximab radioimmunotherapy (RIT) in conjunction with rituximab, followed by maintenance therapy for 1 year. Baseline and 3-month (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) imaging, analyzed according to Deauville criteria, was used to evaluate response and predict prognosis. The overall response rate at 3 months was 99%, with 88% achieving Deauville category 1-3. These satisfactory responders did not reach median time-to-next-treatment, versus a median of 29 months for a category 4-5 response (p < 0.0001). Grade IV hematological toxicity (9%) was self-limited without clinical sequelae. (131)I-rituximab radioimmunotherapy in newly diagnosed, advanced stage, symptomatic follicular NHL is an effective, practical and affordable alternative to existing conventional chemotherapies, with lower toxicity and durable remissions. Response assessment at 3 months by (18)F-FDG PET Deauville five-point scale permits prognostic stratification.
authors: Department of Hematology.
authors: Andrew D
authors: AD
authors: McQuillan
authors: William B G
authors: WB
authors: Macdonald
authors: J Harvey
authors: JH
authors: Turner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D016499:Radioimmunotherapy; D000069283:Rituximab; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; C507388:131I-rituximab
keywords: 131I-rituximab; chimeric anti-CD20; follicular lymphoma; prospective; radioimmunotherapy