title: 90-yttrium-ibritumomab tiuxetan consolidation of fludarabine, mitoxantrone, rituximab in intermediate/high-risk follicular lymphoma: updated long-term results after a median follow-up of 7 years.
abstract: Radioimmunotherapy (RIT) after an induction phase with conventional chemoimmunotherapy became an attractive strategy of consolidation for patients with advanced follicular lymphoma: in particular, in many studies RIT was represented by yttrium-90-ibritumomab tiuxetan ((90) Y-IT). Independently by the different front-line treatment, updates on the long-term follow-up of these studies are needed because the disease course of follicular lymphoma is characterised by multiple relapses and progressively shorter durations of response. We report updated long-term efficacy and toxicity results of a multicenter phase II study on sequential treatment with four cycles of fludarabine, mitoxantrone, and rituximab followed by (90) Y-IT as front-line therapy for untreated patients with intermediate/high-risk follicular lymphoma. With a median follow-up of 84 months, only 19/49 (38.8%) complete response patients relapsed, yielding an estimated long-term disease-free survival of 62.6%. The 7-year overall survival was 72.7%. Four (7.3%) second acute myeloid leukemia occurred, with a median time following RIT of 42 months. A relevant patients' responsiveness to subsequent therapies occurred: approximately 65% of relapsed patients obtained a good clinical response after the second-line treatment. These data represented the first evidence of a real role even in the long period of 90Y-IT after a fludarabine-containing regimen plus rituximab in the treatment of high-risk follicular lymphoma.
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Casadei
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Pellegrini
authors.affiliation: Department of Cellular Biotechnologies and Hematology, "La Sapienza" University, Roma, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pulsoni
authors.affiliation: Department of Cellular Biotechnologies and Hematology, "La Sapienza" University, Roma, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Annechini
authors.affiliation: Division of Hematology, "Federico II" University, Napoli, Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: De Renzo
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Stefoni
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Broccoli
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Gandolfi
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Quirini
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Tonialini
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Morigi
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Argnani
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D060830:Consolidation Chemotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D049268:Positron-Emission Tomography; D012074:Remission Induction; D000069283:Rituximab / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000911:Antibodies, Monoclonal; D000069283:Rituximab; C422802:ibritumomab tiuxetan; D008942:Mitoxantrone; D014740:Vidarabine; C024352:fludarabine
keywords: Advanced; follicular lymphoma; long-term results; radioimmunotherapy