A phase 1/2 trial of high-dose yttrium-90-ibritumomab tiuxetan in combination with high-dose etoposide and cyclophosphamide followed by autologous stem cell transplantation in patients with poor-risk or relapsed non-Hodgkin lymphoma

作者：Auayporn P. Nademanee, Stephen J. Forman, Arturo Molina, Henry C.H. Fung, David D. Smith, Andy Dagis, Cheuk Kwok, Dave M. Yamauchi, Anne-Line Anderson, Peter Falk, Amrita Y. Krishnan, Mark H. Kirschbaum, Neil Martin Kogut, Ryotaro Nakamura, Margaret R O'Donnell, Pablo Miguel Parker, Leslie L. Popplewell, Vinod A. Pullarkat, Roberto Rodríguez, Firoozeh Sahebi, Eileen Smith, David S. Snyder, Anthony Selwyn Stein, Ricardo Tomas Spielberger, Jasmine M. Zain, Christine A. White, Andrew Antony Raubitschek · 发表于：Blood · 年份：2005 · DOI：10.1182/blood-2005-03-1310 · 被引用次数：201 · 研究领域：Lymphoma Diagnosis and Treatment、Lung Cancer Treatments and Mutations、Sarcoma Diagnosis and Treatment

We conducted a phase 1/2 trial of high-dose 90Y-ibritumomab tiuxetan in combination with high-dose etoposide (VP-16) 40 to 60 mg/kg (day -4) and cyclophosphamide 100 mg/kg (day -2) followed by autologous stem cell transplantation (ASCT) in 31 patients with CD20+ non-Hodgkin lymphoma (NHL). Patients underwent dosimetry (day -21) with 5 mCi (185 MBq) 111In-ibritumomab tiuxetan following 250 mg/m2 rituximab, followed a week later by 90Y-ibritumomab tiuxetan to deliver a target dose of 1000 cGy to highest normal organ. Bone marrow biopsy was done on day -7 to estimate radiation dose and stem cells were reinfused when the radiation dose was estimated to be less than 5 cGy. The median 90Y-ibritumomab tiuxetan dose was 71.6 mCi (2649.2 MBq; range, 36.6-105 mCi; range, 1354.2-3885 MBq). Histology included follicular lymphoma (n = 12), diffuse large B-cell (n = 14), and mantle cell (n = 5). The median number of prior chemo-therapy treatments was 2. The treatment was well tolerated. The median times to reach an absolute neutrophil count greater than 500/microL and platelet count more than 20,000/microL were 10 days and 12 days, respectively. There were 2 deaths and 5 relapses. At a median follow-up of 22 months, the 2-year estimated overall survival and relapse-free survival rates are 92% and 78%, respectively. We conclude that high-dose 90Y-ibritumomab tiuxetan can be combined safely with high-dose etoposide and cyclophosphamide without an increase in transplant-related toxicity or de...