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(90)Y-ibritumomab tiuxetan followed by reduced-intensity conditioning and allo-SCT in patients with advanced follicular lymphoma.

Abou-Nassar KE, Stevenson KE, Antin JH, McDermott K, Ho VT, Cutler CS, LaCasce AS, Jacobsen ED, Fisher DC, Soiffer RJ, Alyea EP, Koreth J, Freedman AS - Bone Marrow Transplant. (2011)

Bottom Line: Two-year non-relapse mortality was 18% (±12%).Two-year OS and PFS were 83% (±11%) and 74% (±13%), respectively.This treatment is associated with favorable outcomes including acceptable rates of GVHD and relapse in advanced FL patients, and warrants prospective studies.

View Article: PubMed Central - PubMed

Affiliation: Lymphoma Program, Department of Medical Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA 02115-6084, USA.

ABSTRACT
Reduced-intensity conditioning (RIC) hematopoietic SCT (HSCT) is a potentially curative therapeutic option for patients with advanced follicular lymphoma (FL), but disease relapse remains the most common cause of failure. Radioimmunoconjugates administered before RIC allo-HSCT may enhance cytoreduction and allow more time for GVL effect to develop without the associated toxicity of a myeloablative HSCT. We performed a retrospective study to describe the outcomes of patients with relapsed, refractory or transformed FL who received yttrium-90 ((90)Y)-ibritumomab tiuxetan followed by fludarabine and low-dose BU RIC allogeneic HSCT at the Dana-Farber Cancer Institute between 2006 and 2009, inclusively. Twelve patients were identified with a median age of 55 (40-66) years and a median number of lines of therapy of 5 (2-10). Two patients (17%) had transformed to a more aggressive histology and five (42%) had chemorefractory FL. Cumulative incidences of grade II-IV acute GVHD at 100 days were 17% (±11%) and chronic GVHD at 12 months were 63% (±19%). Two-year non-relapse mortality was 18% (±12%). Two-year OS and PFS were 83% (±11%) and 74% (±13%), respectively. This treatment is associated with favorable outcomes including acceptable rates of GVHD and relapse in advanced FL patients, and warrants prospective studies.

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Cumulative Incidence of cGVHD
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Figure 2: Cumulative Incidence of cGVHD

Mentions: Administration of the RIT was not associated with any grade 3–4 non-hematologic toxicity. The cumulative incidences of aGVHD (grade II–IV) and cGVHD are shown in Figures 1 and 2, respectively and table 2. The incidence of grade II–IV acute GVHD (SE) was 17% (11%) at 100 days and 25% (13%) at 200 days. Only one patient developed grade III–IV aGVHD. Seven patients developed cGVHD, one of which was severe. The 1-year cumulative incidence of cGVHD (SE) was 63% (19%). Two patients died of infectious causes, one of which as a direct consequence of severe aGVHD of the skin, resulting in a 2- year cumulative incidence (SE) of non-relapse mortality (NRM) of 18% (12%).


(90)Y-ibritumomab tiuxetan followed by reduced-intensity conditioning and allo-SCT in patients with advanced follicular lymphoma.

Abou-Nassar KE, Stevenson KE, Antin JH, McDermott K, Ho VT, Cutler CS, LaCasce AS, Jacobsen ED, Fisher DC, Soiffer RJ, Alyea EP, Koreth J, Freedman AS - Bone Marrow Transplant. (2011)

Cumulative Incidence of cGVHD
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3139703&req=5

Figure 2: Cumulative Incidence of cGVHD
Mentions: Administration of the RIT was not associated with any grade 3–4 non-hematologic toxicity. The cumulative incidences of aGVHD (grade II–IV) and cGVHD are shown in Figures 1 and 2, respectively and table 2. The incidence of grade II–IV acute GVHD (SE) was 17% (11%) at 100 days and 25% (13%) at 200 days. Only one patient developed grade III–IV aGVHD. Seven patients developed cGVHD, one of which was severe. The 1-year cumulative incidence of cGVHD (SE) was 63% (19%). Two patients died of infectious causes, one of which as a direct consequence of severe aGVHD of the skin, resulting in a 2- year cumulative incidence (SE) of non-relapse mortality (NRM) of 18% (12%).

Bottom Line: Two-year non-relapse mortality was 18% (±12%).Two-year OS and PFS were 83% (±11%) and 74% (±13%), respectively.This treatment is associated with favorable outcomes including acceptable rates of GVHD and relapse in advanced FL patients, and warrants prospective studies.

View Article: PubMed Central - PubMed

Affiliation: Lymphoma Program, Department of Medical Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA 02115-6084, USA.

ABSTRACT
Reduced-intensity conditioning (RIC) hematopoietic SCT (HSCT) is a potentially curative therapeutic option for patients with advanced follicular lymphoma (FL), but disease relapse remains the most common cause of failure. Radioimmunoconjugates administered before RIC allo-HSCT may enhance cytoreduction and allow more time for GVL effect to develop without the associated toxicity of a myeloablative HSCT. We performed a retrospective study to describe the outcomes of patients with relapsed, refractory or transformed FL who received yttrium-90 ((90)Y)-ibritumomab tiuxetan followed by fludarabine and low-dose BU RIC allogeneic HSCT at the Dana-Farber Cancer Institute between 2006 and 2009, inclusively. Twelve patients were identified with a median age of 55 (40-66) years and a median number of lines of therapy of 5 (2-10). Two patients (17%) had transformed to a more aggressive histology and five (42%) had chemorefractory FL. Cumulative incidences of grade II-IV acute GVHD at 100 days were 17% (±11%) and chronic GVHD at 12 months were 63% (±19%). Two-year non-relapse mortality was 18% (±12%). Two-year OS and PFS were 83% (±11%) and 74% (±13%), respectively. This treatment is associated with favorable outcomes including acceptable rates of GVHD and relapse in advanced FL patients, and warrants prospective studies.

Show MeSH
Related in: MedlinePlus