title: 90Y-Ibritumomab-Tiuxetan Consolidation Therapy for Advanced-Stage Mantle Cell Lymphoma After First-Line Autologous Stem Cell Transplantation: Is It Time for a Step Forward?
abstract: BACKGROUND
  Mantle cell lymphoma (MCL) is an aggressive lymphoma with a dismal prognosis because of numerous relapses. Because the most promising results have been obtained with immunochemotherapy followed by autologous cell stem transplantation (ASCT), we evaluated the efficacy of yttrium-90 ibritumomab ((90)Y-IT) consolidation after such an intensive treatment.
  
  
  METHODS
  We retrospectively assessed 57 patients affected by intermediate or high-risk MCL in complete remission (CR) or partial remission (PR) after 3 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [Oncovin], prednisolone) plus 3 cycles of R-DHAP (dexamethasone, cytarabine [Ara-C], cisplatin [platinum]) followed by ASCT and additional consolidation treatment with (90)Y-IT in 28 cases. All patients underwent 2 years of rituximab maintenance.
  
  
  RESULTS
  After ASCT, 94% achieved CR and 4% achieved PR. The median follow-up was 6.2 years (range, 1.8-9.7 years). Treatment intensification was well tolerated and led to a significantly longer response duration in comparison to standard treatment. In contrast to the historical cohort, the addition of (90)Y-IT seems to overcome important risk factors such as Mantle Cell Lymphoma International Prognostic Index (MIPI) score and bone marrow infiltration.
  
  
  CONCLUSIONS
  In the present retrospective analysis, immunochemotherapy followed by ASCT resulted in a very high response rate, and subsequent (90)Y-IT consolidation significantly reduced the number of relapses and increased survival, suggesting that (90)Y-IT consolidation might be a valid option in first-line treatment. However, a prospective confirmatory trial is warranted.
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy; Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, Messina, Italy; Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: patriziamondello@hotmail.it.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mondello
authors.affiliation: Universitätsklinik für Innere Medizin V, Hämatologie & Onkologie, Innsbruck, Austria.
authors.forename: Normann
authors.initials: N
authors.lastname: Steiner
authors.affiliation: Universitätsklinik für Innere Medizin V, Hämatologie & Onkologie, Innsbruck, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Willenbacher
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Arrigo
authors.affiliation: Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cuzzocrea
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pitini
authors.affiliation: Universitätsklinik für Innere Medizin V, Hämatologie & Onkologie, Innsbruck, Austria; Department of Hematology and CBMT, Bolzano, Italy.
authors.forename: Michael
authors.initials: M
authors.lastname: Mian
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D016499:Radioimmunotherapy / Q000379:methods; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D000069283:Rituximab / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; C422802:ibritumomab tiuxetan; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: (90)Y-ibritumomab tiuxetan; Autologous transplantation; Consolidation treatment; Lymphoma; MCL