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Repeated radioimmunotherapy with 131I-rituximab for patients with low-grade and aggressive relapsed or refractory B cell non-Hodgkin lymphoma

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Abstract

Purpose

A single treatment of 131I-rituximab in patients with B cell non-Hodgkin lymphoma (NHL) showed a modest rate of response (29 %) in a relatively short duration (median 2.9 months). On the basis of this result, we investigated whether repeated treatment with 131I-rituximab could improve the response.

Patients and methods

Thirty-one patients with relapsed or refractory B cell NHL received unlabeled rituximab (70 mg) immediately prior to the administration of a therapeutic dose of 131I-rituximab. The tumor response was evaluated 1 month later by contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Radioimmunotherapy (RIT) was repeated at 4-week intervals.

Results

A total of 87 cycles of RIT were administered. Repeated RIT yielded twofold increases in response rate (68 %) and in median response duration (8.6 months). This protocol also induced a favorable response in patients with an aggressive histology compared to that induced by a single treatment (50 vs. 9 %, respectively, p = 0.063). The toxicities were principally hematologic with grade 4 thrombocytopenia occurring in 12 % and neutropenia occurring in 17 % of the 85 assessable cycles.

Conclusions

Compared to a single treatment, repeated RIT with 131I-rituximab increased the response rate and duration for patients with relapsed or refractory B cell NHL, including those with an aggressive histology.

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Acknowledgments

The authors thank all the patients and their families who participated in this study. We also thank the study coordinator Kyoung Ja Jung and Young Sub Lee who analyzed the dosimetry of this study. This study was supported by the Radiological Translational Research Program of the Korea Institute of Radiological and Medical Sciences (50450-2011) and the Nuclear R&D program of the Korea Science and the Engineering Foundation (2011-0002286) funded by the Ministry of Education, Science and Technology.

Conflict of interest

None.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea

    Hye Jin Kang & Dong-Yeop Shin

  2. Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea

    Seung-Sook Lee

  3. Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 139-706, Republic of Korea

    Byung Hyun Byun, Ilhan Lim, Chang Woon Choi & Sang Moo Lim

  4. Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea

    Kyeong Min Kim

  5. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Cheolwon Suh

  6. Division of Hematology/Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Won Seog Kim

  7. Department of Internal Medicine, VHS Medical Center, Seoul, Republic of Korea

    Seung-Hyun Nam

  8. Department of Internal Medicine, Dankook University College of Medicine, Seoul, Republic of Korea

    Soon Il Lee

  9. Hematology-Oncology Clinic, Research Institute and Hospital, National Cancer Center, Seoul, Republic of Korea

    Hyeon Seok Eom

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  1. Hye Jin Kang
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  10. Soon Il Lee
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  12. Dong-Yeop Shin
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Corresponding author

Correspondence to Sang Moo Lim.

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Kang, H.J., Lee, SS., Byun, B.H. et al. Repeated radioimmunotherapy with 131I-rituximab for patients with low-grade and aggressive relapsed or refractory B cell non-Hodgkin lymphoma. Cancer Chemother Pharmacol 71, 945–953 (2013). https://doi.org/10.1007/s00280-013-2087-z

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  • DOI: https://doi.org/10.1007/s00280-013-2087-z

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