Annals of Hematology

, Volume 90, Issue 11, pp 1307–1315

Tandem high-dose therapy in relapsed and refractory B-cell lymphoma: results of a prospective phase II trial of myeloablative chemotherapy, followed by escalated radioimmunotherapy with 131I-anti-CD20 antibody and stem cell rescue

  • Karin Hohloch
  • Carsten Oliver Sahlmann
  • Vijai J. Lakhani
  • Gerald Wulf
  • Bertram Glaß
  • Justin Hasenkamp
  • Johannes Meller
  • Joachim Riggert
  • Lorenz Trümper
  • Frank Griesinger
Original Article

DOI: 10.1007/s00277-011-1199-y

Cite this article as:
Hohloch, K., Sahlmann, C.O., Lakhani, V.J. et al. Ann Hematol (2011) 90: 1307. doi:10.1007/s00277-011-1199-y

Abstract

A phase II trial evaluated safety, feasibility and efficacy of a sequential tandem approach combining myeloablative BEAM chemotherapy and autologous stem cell transplantation (ASCT) with myeloablative radioimmunotherapy (HD-RIT), with 131I-anti-CD20 antibody (131I-rituximab), followed by a second ASCT in patients with relapsed or refractory CD20+ B-cell lymphoma. According to protocol, 16 patients with relapsed (n = 14) and refractory (n = 2) CD20+ B-cell lymphoma received salvage therapy with rituximab and Dexa-BEAM, followed by BEAM (HD chemotherapy) and high-dose myeloablative radioimmunotherapy 2–6 months after BEAM. Nine of 16 patients received HD-RIT; seven patients were excluded before HD-RIT because of toxicity or progressive disease. Disease histologies were follicular lymphoma (FL) grades 1 and 2 (n = 4), transformed follicular (FL 3b; n = 6), diffuse large B-cell (DLBCL; n = 4), mantle cell (n = 1) and marginal zone lymphoma (n = 1). After a median follow-up of 50.4 months for OS and 39.7 months for progression-free survival (PFS), estimated 4-year OS and PFS were 67% and 64%, respectively. The estimated 4-year OS and PFS for patients with FL were 80% and 78%, respectively. Toxicity was significant, including one fatal outcome due to pneumonitis. Tandem transplants consisting of HD chemotherapy followed by HD-RIT with 131I-coupled anti-CD20 are manageable and effective but toxic treatment modalities for relapsed poor prognosis CD20+ B-NHL.

Keywords

RadioimmunotherapyB-Cell lymphomaStem cell transplantationRelapseTandem therapy

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Karin Hohloch
    • 1
  • Carsten Oliver Sahlmann
    • 3
  • Vijai J. Lakhani
    • 1
  • Gerald Wulf
    • 1
  • Bertram Glaß
    • 4
  • Justin Hasenkamp
    • 1
  • Johannes Meller
    • 3
  • Joachim Riggert
    • 2
  • Lorenz Trümper
    • 1
  • Frank Griesinger
    • 5
  1. 1.Department of Hematology and OncologyUniversity Medicine, Georg-August-UniversityGöttingenGermany
  2. 2.Department of Transfusion MedicineUniversity Medicine, Georg-August-UniversityGöttingenGermany
  3. 3.Department of Nuclear MedicineUniversity Medicine, Georg-August-UniversityGöttingenGermany
  4. 4.Section for Stem Cell Transplantation, Department of HematologyAsklepios HospitalHamburgGermany
  5. 5.Department of Medical OncologyPius HospitalOldenburgGermany