| Autor: |
Dispenzieri, A, D'Souza, A, Gertz, M A, Laumann, K, Wiseman, G, Lacy, M Q, LaPlant, B, Buadi, F, Hayman, S R, Kumar, S K, Dingli, D, Hogan, W J, Ansell, S M, Gastineau, D A, Inwards, D J, Micallef, I N, Porrata, L F, Johnston, P B, Litzow, M R, Witzig, T E |
| Zdroj: |
Bone Marrow Transplantation; October 2017, Vol. 52 Issue: 10 p1372-1377, 6p |
| Abstrakt: |
This phase 1 study (clinical trial NCT00477815) was conducted to determine the maximum tolerated dose (MTD) of yttrium-90 ibritumomab tiuxetan (90Y-Zevalin) with high dose melphalan (HDM) therapy in multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT). In a 3+3 trial design, 30 patients received rituximab 250 mg/m2with indium-111 ibritumomab tiuxetan (111In-Zevalin) for dosimetry (day −22); rituximab 250 mg/m2with escalating doses of 90Y-Zevalin (day −14); melphalan 100 mg/m2(days −2,−1) followed by ASCT (day 0) and sargramostim (GM-CSF, day 0) until neutrophil engraftment. Each patient’s 111In-Zevalin dosimetry data were used to calculate the dose of 90Y-Zevalin (in mCi) to deliver 10, 12, 14, 16, 18 or 20 Gy to the liver. Dose limiting toxicities were seen in 3 patients. The overall response rate was 73% (22/30) with stringent complete response in 2 patients; complete response, 5; very good partial response, 12; and partial response, 3. The median PFS was 16.5 months and the median overall survival was 63.4 months. In MM, the MTD of 90Y-Zevalin with HDM is 18 Gy to the liver. The addition of radiation with novel delivery methods such as radioimmunotherapy combined with standard transplant regimens warrants further study. |
| Databáze: |
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