Skip to main content

Advertisement

SpringerLink
Log in

Results of a national consensus workshop: therapeutic algorithm in patients with follicular lymphoma—role of radioimmunotherapy

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

Radioimmunotherapy (RIT) was approved for the treatment of relapsed or refractory CD20-positive follicular lymphoma (FL), subsequent to rituximab containing primary therapy. However, an increasing number of clinical studies have suggested that RIT may be more efficacious in an earlier phase of the disease. Therefore, a consensus meeting was held in May 2005 to define the optimal setting of RIT in the therapeutic algorithm of patients with advanced stage of FL. RIT is an established therapeutic option in relapsed FL. According to the reviewed data, RIT should be preferably used as consolidation after initial tumor debulking. First-line RIT may be applied in patients not appropriate for chemotherapy induction. Current study concepts evaluate the role of RIT consolidation in combination with antibody maintenance to achieve a potentially curative approach even in patients with advanced stage disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Winter J (2004) Low-grade lymphoma. Hematology: American Society of Hematology, Educational Program Book, pp 208–212

  2. Horning SJ, Rosenberg SA (1984) The natural history of initially untreated low-grade non-Hodgkin’s lymphomas. N Engl J Med 311:1471–1475

    Article  PubMed  CAS  Google Scholar 

  3. Young RC et al (1988) The treatment of indolent lymphomas: watchful waiting v aggressive combined modality treatment. Semin Hematol 25(2):11–16

    PubMed  CAS  Google Scholar 

  4. Horning SJ (2000) Follicular lymphoma: have we made any progress? Ann Oncol 11(Suppl 1):23–27

    Article  PubMed  Google Scholar 

  5. Brice P et al (1997) Comparison in low-tumor-burden follicular lymphomas between an initial no treatment policy, prednimustine, or interferon alfa: a randomized study from the Groupe d’Etude des Lymphomes Folliculaires. Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol 15:1110–1117

    PubMed  CAS  Google Scholar 

  6. Ardeshna KM et al (2003) Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomized controlled trial. Lancet 362:516–522

    Article  PubMed  CAS  Google Scholar 

  7. Tsimberidou AM et al (2002) Fludarabine, mitoxantrone, dexamethasone (FND) compared with an alternating triple therapy (ATT) regimen in patients with stage IV indolent lymphoma. Blood 100(13):4351–4357

    Article  PubMed  CAS  Google Scholar 

  8. Rohatiner AZS et al (2005) Meta-analysis to evaluate the role of interferon in follicular lymphoma. J Clin Oncol 23:2215–2223

    Article  PubMed  CAS  Google Scholar 

  9. Schouten HC et al (2003) High-dose therapy improves progression-free survival and survival in relapsed follicular non-Hodgkin’s lymphoma: results from the randomized European CUP trial. J Clin Oncol 21(21):3918–3927

    Article  PubMed  CAS  Google Scholar 

  10. Lenz G et al (2004) Myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission prolongs progression-free survival in follicular lymphoma: results of a prospective, randomized trial of the German Low-Grade Lymphoma Study Group. Blood 104:2667–2674

    Article  PubMed  CAS  Google Scholar 

  11. Mc Laughlin P et al (1998) Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncol 16:2825–2833

    Google Scholar 

  12. Ghielmini M et al (2004) Prolonged treatment with rituximab in patients with follicular lymphoma significantly increases event-free survival and response duration compared with standard weekly x 4 schedule. Blood 103(12):4416–4423

    Article  PubMed  CAS  Google Scholar 

  13. Hiddemann W et al (2005) Combined immuno-chemotherapy (R-CHOP) significantly improves time to treatment failure in first-line therapy of follicular lymphoma. Results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). Blood 106:3725–3732

    Article  PubMed  CAS  Google Scholar 

  14. Herold M et al (2004) Results of a prospective open-label phase III-trial: R-MCP vs. MCP alone in untreated advanced indolent lymphoma and MCL. Blood 104 (Suppl. 11):169a (abstract # 584)

  15. Marcus R et al (2005) CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood 105(4):1417–1423

    Article  PubMed  CAS  Google Scholar 

  16. Dreyling MH et al (2005) Combined immuno-chemotherapy (R-FCM) results in superior remission rates and overall survival in recurrent follicular and mantle cell lymphoma: follow-up of a prospective randomized trial of the German Low-Grade Lymphoma Study Group (GLSG). Proc Am Soc Clin Oncol 23:567s (abstract #6528)

    Google Scholar 

  17. Hiddemann W et al (2005) Rituximab maintenance following a Rituximab containing chemotherapy significantly prolongs the duration of response in patients with relapsed follicular and mantle cell lymphomas: Results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group (GLSG). Blood 106(11):270a (abstract #920)

    Google Scholar 

  18. Radioimmuntherapie mit [90Y]-Ibritumomab-Tiuxetan [90Y]-Zevalin®. Empfehlung der Strahlenschutzkommission. 198. Sitzung am 17.02.2005

  19. Witzig TE et al (2003) Safety of yttrium-90 ibritumomab tiuxetan radioimmunotherapy for relapsed low-grade, follicular, or transformed non-Hodgkin’s lymphoma. J Clin Oncol 21:1263–1270

    Article  PubMed  CAS  Google Scholar 

  20. Witzig TE et al (2002) Randomized controlled trial of yttrium-90-labeled ibritumomab tiuxetan radioimmunotherapy versus rituximab immunotherapy for patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin’s lymphoma. J Clin Oncol 20(10):2453–2463

    Article  PubMed  CAS  Google Scholar 

  21. Gordon LI et al (2004) Yttrium 90-labeled ibritumomab tiuxetan radioimmunotherapy produces high response rates and durable remissions in patients with previously treated B-cell lymphoma. Clin Lymphoma 5(2):98–101

    PubMed  CAS  Google Scholar 

  22. Gordon LI et al (2004) Durable responses after ibritumomab tiuxetan radioimmunotherapy for CD20+ B-cell lymphoma: long-term follow-up of a phase I/II-study. Blood 103:4429–4431

    Article  PubMed  CAS  Google Scholar 

  23. Emmanouilides C et al (2006) Treatment with yttrium 90 ibritumomab tiuxetan at early relapse is safe and effective in patients with previously treated B-cell non-Hodgkin’s lymphoma. Leuk Lymphoma 47(4):629–636

    Article  PubMed  CAS  Google Scholar 

  24. Schilder RJ et al (2004) Follow-up results of a phase II-study of ibritumomab radioimmunotherapy in patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin’s lymphoma and mild thrombocytopenia. Cancer Biother Radiopharm 19(4):478–481

    PubMed  CAS  Google Scholar 

  25. Schilder RJ et al (2005) Yttrium 90 ibritumomab tiuxetan is safe and effective in older patients with relapsed or refractory NHL. Proc Am Soc Clin Oncol 23:575s (abstract #6562)

    Google Scholar 

  26. Gregory SA et al (2005) Superior outcomes associated with earlier use: experience with tositumomab and iodine 131I tositumomab in 1,177 patients with low-grade, follicular, and transformed non-Hodgkin’s lymphoma (NHL). Proc Am Soc Clin Oncol 23:575s (abstract #6561)

    Google Scholar 

  27. Kaminski MS et al (2005) 131I-tositumomab therapy as initial treatment for follicular lymphoma. N Engl J Med 352:441–449

    Article  PubMed  CAS  Google Scholar 

  28. Sweetenham JW et al (2004) Efficacy and safety of Yttrium 90 (90Y) ibritumomab tiuxetan (Zevalin®) therapy with rituximab maintenance in patients with untreated low-grade follicular lymphoma. Blood 104(11):720a (abstract #2632)

    Google Scholar 

  29. Horning SJ et al (2005) Efficacy and safety of tositumomab and iodine-131 tositumomab (Bexxar) in B-cell lymphoma, progressive after rituximab. J Clin Oncol 23(4):712–719

    Article  PubMed  CAS  Google Scholar 

  30. Czuczman MS et al (2002) Multivariate analysis of prognostic factors correlated with response to 90Y ibritumomab tiuxetan (Zevalin) radioimmunotherapy for non-Hodgkin’s lymphoma. Proc Am Soc Clin Oncol 21:266a (abstract #1062)

    Google Scholar 

  31. Kaminski MS et al (2005) Tositumomab and iodine 131I tositumomab: efficacy and safety in 141 patients with previously untreated low-grade non-Hodgkin’s lymphoma (NHL). Proc Am Soc Clin Oncol 23:575s (abstract #6560)

    Google Scholar 

  32. Press OW et al (2003) A phase 2 trial of CHOP chemotherapy followed by tositumomab/iodine I 131 tositumomab for previously untreated follicular non-Hodgkin lymphoma: Southwest Oncology Group Protocol S9911. Blood 102(5):1606–1612

    Article  PubMed  CAS  Google Scholar 

  33. Shipley DL et al (2004) Phase II trial of Rituximab and short duration chemotherapy followed by 90 Y ibritumomab tiuxetan as first-line treatment for patients with follicular lymphoma: a Minnie Pearl Cancer Research Network phase II trial. Proc Am Soc Clin Oncol 23:560 (abstract #6519)

    Google Scholar 

  34. Shipley DL et al (2005) Rituximab with short duration chemotherapy followed by 90 Y ibritumomab tiuxetan as first-line treatment for patients with follicular lymphoma: update of a Minnie Pearl Cancer Research Network phase II trial. Proc Am Soc Clin Oncol 23:579s (abstrac #6577)

    Google Scholar 

  35. Schilder R et al (2004) Subsequent therapy for non-Hodgkin’s Lymphoma is feasible after radioimmunotherapy with yttrium-90 ibritumomab tiuxetan (Zevalin®). Hem J 5(Suppl 2):S7 (abstract #019)

    Google Scholar 

  36. Ansell SM et al (2004) Antilymphoma treatments given subsequent to yttrium 90 ibritumomab tiuxetan are feasible in patients with progressive Non-Hodgkin’s lymphoma: a review of the literature. Clin Lymphoma 5(3):202–204

    Article  PubMed  Google Scholar 

  37. Gordon L et al (2001) High-dose therapy can be safely and successfully administered after Zevalin® treatment. Proc Am Soc Clin Oncol 20:232b (abstract #2681)

    Google Scholar 

  38. Nademanee A et al (2005) 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. J Clin Oncol 106:2896–2902

    CAS  Google Scholar 

  39. Winter J et al (2004) Zevalin® dose-escalation followed by high-dose BEAM and autologous peripheral blood progenitor cell (PBPC) transplant in non-Hodgkin’s lymphoma. Blood 103(11):329a (abstract #1162)

    Google Scholar 

  40. Krishnan AY et al (2005) The outcome of ZBEAM, a regimen combining 90Y ibritumomab tiuxetan with high dose chemotherapy in elderly patients with non-Hodgkin’s lymphoma (NHL). Proc Am Soc Clin Oncol 23:576s (abstract #6566)

    Google Scholar 

  41. Weigert O et al (2006) Efficacy of radioimmunotherapy with (90Y) ibritumomab tiuxetan is superior as consolidation in relapsed or refractory mantle cell lymphoma: results of two phase II trials of the European MCL Network and the PLSG. Proc Am Soc Clin Oncol 24:422s (abstract #7502)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine III, Grosshadern, Ludwig Maximilians University, Munich, Germany

    M. Dreyling

  2. Department of Hematology and Oncology, University of Göttingen, Göttingen, Germany

    L. Trümper

  3. Department of Hematology and Oncology, Technical University of Munich, Munich, Germany

    C. von Schilling

  4. Medical Clinic III, University of Frankfurt, Frankfurt Main, Germany

    M. Rummel

  5. German Leukemia and Lymphoma Help (DLH), Bonn, Germany

    U. Holtkamp & A. Waldmann

  6. Münster, Germany

    J. Wehmeyer

  7. Department of Hematology and Oncology, University of Rostock, Rostock, Germany

    M. Freund

Authors
  1. M. Dreyling
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Trümper
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. von Schilling
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Rummel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. U. Holtkamp
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Waldmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Wehmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Freund
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Dreyling.

Additional information

J. Wehmeyer is in hematological–oncological private practice.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dreyling, M., Trümper, L., von Schilling, C. et al. Results of a national consensus workshop: therapeutic algorithm in patients with follicular lymphoma—role of radioimmunotherapy. Ann Hematol 86, 81–87 (2007). https://doi.org/10.1007/s00277-006-0207-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-006-0207-0

Keywords

Search

Navigation