title: Phase II Study of Yttrium-90 Ibritumomab Tiuxetan Plus High-Dose BCNU, Etoposide, Cytarabine, and Melphalan for Non-Hodgkin Lymphoma: The Role of Histology.
abstract: Standard-dose90yttrium-ibritumomab tiuxetan (.4 mci/kg) together with high-dose BEAM (BCNU, etoposide, cytarabine, and melphalan) (Z-BEAM) has been shown to be a well-tolerated autologous hematopoietic stem cell transplantation preparative regimen for non-Hodgkin lymphoma. We report the outcomes of a single-center, single-arm phase II trial of Z-BEAM conditioning in high-risk CD20+non-Hodgkin lymphoma histologic strata: diffuse large B cell (DLBCL), mantle cell, follicular, and transformed. Robust overall survival and notably low nonrelapse mortality rates (.9% at day +100 for the entire cohort), with few short- and long-term toxicities, confirm the safety and tolerability of the regimen. In addition, despite a high proportion of induction failure patients (46%), the promising response and progression-free survival (PFS) rates seen in DLBCL (3-year PFS: 71%; 95% confidence interval, 55 to 82%), support the premise that the Z-BEAM regimen is particularly effective in this histologic subtype. The role of Z-BEAM in other strata is less clear in the context of the emergence of novel agents.
authors.affiliation: Judy and Bernard Briskin Center for Multiple Myeloma Research, City of Hope, Duarte, California; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California. Electronic address: akrishnan@coh.org.
authors.forename: Amrita Y
authors.initials: AY
authors.lastname: Krishnan
authors.affiliation: Department of Information Sciences, City of Hope, Duarte, California.
authors.forename: Joycelynne
authors.initials: J
authors.lastname: Palmer
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
authors.forename: Auayporn P
authors.initials: AP
authors.lastname: Nademanee
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
authors.forename: Robert
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Popplewell
authors.affiliation: Department of Information Sciences, City of Hope, Duarte, California.
authors.forename: Ni-Chun
authors.initials: NC
authors.lastname: Tsai
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
authors.forename: James F
authors.initials: JF
authors.lastname: Sanchez
authors.affiliation: Clinical Trials Office, City of Hope, Duarte, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Simpson
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California; Southern California Kaiser Permanente Bone Marrow Transplant Program, Los Angeles, California.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Spielberger
authors.affiliation: Department of Diagnostic Radiology, City of Hope, Duarte, California.
authors.forename: Dave
authors.initials: D
authors.lastname: Yamauchi
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forman
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018951:Antigens, CD20 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006652:Histological Techniques; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D012074:Remission Induction; D016879:Salvage Therapy / Q000379:methods; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D018951:Antigens, CD20; D003561:Cytarabine; C422802:ibritumomab tiuxetan; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine
keywords: (90)yttrium-ibritumomab tiuxetan; Autologous stem cell transplantation; BEAM; Radioimmunotherapy; Zevalin