Yttrium-90 ibritumomab tiuxetan (Zevalin) followed by BEAM (Z-BEAM) conditioning regimen and autologous stem cell transplantation (ASCT) in relapsed or refractory high-risk B-cell non-Hodgkin lymphoma (NHL): a single institution Italian experience.

Autor: Ciochetto C; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy. ciochettochiara@gmail.com., Botto B; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Passera R; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Bellò M; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Benevolo G; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Boccomini C; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Castellino A; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Chiappella A; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Freilone R; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Nicolosi M; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Orsucci L; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Pecoraro C; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Pregno P; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Bisi G; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy., Vitolo U; Hematology Department, Città della Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2018 Sep; Vol. 97 (9), pp. 1619-1626. Date of Electronic Publication: 2018 Apr 16.
DOI: 10.1007/s00277-018-3328-3
Abstrakt: Chemo-refractory NHL has a very poor outcome; the addiction of RIT to salvage regiment pre ASCT had recently demonstrated promising results.We performed a retrospective sequential study to determine the feasibility of standard Zevalin with BEAM in high-risk relapse/refractory NHL. A matched cohort analysis with a group treated with standard BEAM without Zevalin was performed as secondary endpoint. Between October 2006 and January 2013, 37 NHL patients at high risk for progression or early (< 1 year) or multiple relapses were treated with Z-BEAM and ASCT after R-DHAP or R-ICE as salvage therapy. Clinical characteristics were 19 refractory and 18 early or multiple relapse; 16 patients received 1, and 21 had 2 or more previous rituximab-containing chemotherapy. At the end of treatment, response was CR 22 (59%), PR 10 (27%), PD 4 (11%), and toxic death (TD) 1 (3%). With a median follow up of 61 months, 3-year PFS was 61% and OS 61%. Fifteen patients died, 12 of lymphoma. Comparison with 21 treated with BEAM alone showed a numerical higher 3-yr PFS rate in favor of Z-BEAM but not statistically significant (57 vs 48%). With the limitation of the small sample subgroup analysis, a significant benefit was observed in relapsed patients for PFS (78% Z-BEAM vs 22% BEAM p = 0.016) and OS (83% Z-BEAM vs 22% BEAM p = 0.001). In relapsed/refractory high-risk NHL, Z-BEAM+ASCT is able to achieve a good ORR. Three-year PFS is promising for early relapsed patients but is not satisfactory for those with refractory disease.
Databáze: MEDLINE
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