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Clinical outcomes of post-remission therapy using 90yttrium ibritumomab tiuxetan (Zevalin®) for high-risk patients with diffuse large B-cell lymphoma

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Abstract

This phase II trial evaluated the efficacy and safety of tandem consolidation using 90yttrium ibritumomab tiuxetan (90Y-IT) and high-dose therapy (HDT) with autologous peripheral blood stem cell transplantation (PBSCT) in high-risk patients with diffuse large B-cell lymphoma (DLBCL) who were in primary remission. Eleven patients with high-risk DLBCL were enrolled. All patients had achieved complete or partial response after six to eight cycles of rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as a frontline chemotherapy. Subsequently, the patients received one to two courses of ifosfamide-containing regimen for peripheral blood stem cell mobilization and harvesting. First consolidation with 90Y-IT was performed, followed by second consolidation using HDT with PBSCT. All patients received 90Y-IT therapy, but three patients did not undergo PBSCT. During the median follow-up period of 18.1 months, 9 of 11 patients exhibited disease progression, and 8 patients died. The estimated 2-year progression-free survival was 18.2%, and overall survival was 36.4%. Adverse events following 90Y-IT consolidation were primarily transient hematologic toxicities. The present pilot study suggests that tandem consolidation therapy using 90Y-IT followed by HDT with autologous PBSCT is not feasible for treatment of high-risk patients with DLBCL in remission after R-CHOP. In addition, this treatment failed to provide beneficial effects for the clinical outcome of subsequent PBSCT.

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Acknowledgments

We are grateful to Bayer Schering Pharma, Seoul, Korea for supplying 90Y-IT (Zevalin®). We would also like to thank Byung-Young Ahn, Geul-Soon Han, and Seung-Won Choi for providing excellent technical assistance.

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Authors and Affiliations

  1. Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, #505, Banpo-dong, Seocho-gu, Seoul, South Korea, 137-040

    Sung-Eun Lee & Seok-Goo Cho

  2. Department of Radiology, Catholic Lymphoma Study Group (CULG), The Catholic University of Korea College of Medicine, Seoul, South Korea

    Eun Ji Han, Sung Hoon Kim, Hyung Sun Sohn & Seung Eun Jung

  3. Department of Hospital Pathology, Catholic Lymphoma Study Group (CULG), The Catholic University of Korea College of Medicine, Seoul, South Korea

    Gyeongsin Park

  4. Department of Radiation Oncology, Catholic Lymphoma Study Group (CULG), The Catholic University of Korea College of Medicine, Seoul, South Korea

    Byung-Ock Choi & Sang-Nam Lee

  5. Department of Opthalmology, Catholic Lymphoma Study Group (CULG), The Catholic University of Korea College of Medicine, Seoul, South Korea

    Suk-Woo Yang

  6. Department of Laboratory Medicine, Catholic Lymphoma Study Group (CULG), The Catholic University of Korea College of Medicine, Seoul, South Korea

    Kyungja Han

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  1. Eun Ji Han
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  2. Sung-Eun Lee
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  3. Sung Hoon Kim
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  4. Hyung Sun Sohn
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  5. Seung Eun Jung
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  6. Gyeongsin Park
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  7. Byung-Ock Choi
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  8. Sang-Nam Lee
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  9. Suk-Woo Yang
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  10. Kyungja Han
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  11. Seok-Goo Cho
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Correspondence to Seok-Goo Cho.

Additional information

Eun Ji Han and Sung-Eun Lee equally contributed in this study.

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Han, E.J., Lee, SE., Kim, S.H. et al. Clinical outcomes of post-remission therapy using 90yttrium ibritumomab tiuxetan (Zevalin®) for high-risk patients with diffuse large B-cell lymphoma. Ann Hematol 90, 1075–1082 (2011). https://doi.org/10.1007/s00277-011-1191-6

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  • DOI: https://doi.org/10.1007/s00277-011-1191-6

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