90Y-Ibtritumomab as a Single Agent for De Novo or Transformed Diffuse Large B Cell Lymphoma

Autor: Gorusu Madhavi, Edwards L. Richard, Syed Fazl Ali Bilgrami, Joel Silver, Syed S. Ali, Kaplan Bruce, Stephen I. Firshein
Rok vydání: 2007
Předmět:
Zdroj: Blood. 110:4505-4505
ISSN: 1528-0020
0006-4971
Popis: BACKGROUND: 90Y-Ibritumomab is approved for use in relapsed/refractory follicular non-Hodgkin’s lymphoma (NHL), and for transformed lymphoma. It is also being studied in the setting of relapsed diffuse large B cell lymphoma. AIM: To determine response rate and duration, and toxicity of 90Y-ibritumomab in relapsed/refractory diffuse large B-cell (de novo or transformed) lymphoma (DLBCL). METHODS: Permission for the study was obtained from the Institutional Review Boards of St. Francis Hospital and Harford Hospital, Hartford, CT, respectively. Patients who had received 90Y-ibritumomab for DLBCL were identified. A retrospective chart review was conducted to determine patient and disease characteristics, safety and efficacy of 90Y-ibritumomab. RESULTS: A total of 9 individuals received 90Y-ibritumomab between May, 2004, and November, 2006. Their median age was 71 years (48–90 years) and male:female ratio 4:5. Pathology at initial diagnosis was de novo DLBCL (n=4), and follicular (n=4) or small B cell NHL (n=1). The interval to transformation to DLBCL in the latter 5 patients was a median of 7 years (0.5–10 years). At original diagnosis, 5 patients had B symptoms, 3 had bone marrow involvement, 5 had CD10-positivity, 6 had intermediate high or high risk features, and only one had a cytogenetic abnormality (t14;18;22).The median number of prior treatment regimens was 2 (1–3). Seven had received radiation. The last dose of rituximab was administered a median of 9 months (1 week-18 months) previously. Patients were refractory to (n=4) or relapsed after (n=5) the last treatment (chemotherapy and/or rituximab). The median duration of response to last treatment was 2.5 months (1–12 months). The interval from diagnosis of de novo or transformed DLBCL to treatment with 90Y-ibritumomab was a median of 12.5 months (6–35 months). At the time of treatment with 90Y-ibtitumomab, 3 patients had B symptoms, and 4 had CONCLUSIONS: 90Y - ibritumomab is well tolerated in patients with relapsed/refractory DLBCL but response rates are low and response durations short. Outcome was poor whether or not patients had de novo or transformed DLBCL. 90Y-Ibritumomab cannot be recommended as a single agent in relapsed/refractory patients with DLBCL.
Databáze: OpenAIRE
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