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Radioimmunotherapy in follicular lymphomas, a retrospective analysis of the Polish Lymphoma Research Group’s (PLRG) experience
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Abstract
MATERIAL AND METHODS: Twenty-one patients with follicular lymphoma, after failing 2-5 lines of previous treatment, were subjected to radioimmunotherapy in three Polish Lymphoma Research Group (PLRG) centres. Ibritumomab infusion was followed by 2 doses of Rituximab (250 mg/m2 at day -7 and 0) to enhance its biodistribution. Radioimmunoconjugate was prepared in the Nuclear Medicine Departments of participating centres based on patient weight and full blood count results (14.8 MBq/kg, max 1200 MBq, reduced to 11.1 MBq/kg in cases with blood platelet 100 000-150 000 or leukocytes 1500-2000).
14.8 MBq/kg (0.4 mCi/kg)
100 thousand to 149 thousand/mm3 platelets
11.1 MBq/kg (0.3 mCi/kg)
RESULTS: The primary endpoint of the study was the assessment of response rate and haematological toxicity. Objective responses were observed in all patients, with 10 partial and 12 complete regressions. Cytopenia, starting 3-4 weeks after radioimmunotherapy, reflected haematological toxicity - the only important side effect. Thrombocytopenia was more pronounced, with platelet counts of < 50,000/ul in every second patient. One patient developed myelodysplastic syndrome 21 months after the procedure. After the medium time of follow up over 2 years, 2 patients died. Median progression free survival (secondary study endpoint) was 15 months.
CONCLUSIONS: Ibritumomab radioimmunotherapy is an efficient method of palliation treatment of heavily pre-treated follicular lymphoma patients, failing numerous previous treatment lines. Earlier application increases the number of complete responses and prolongs progression free survival.
Abstract
MATERIAL AND METHODS: Twenty-one patients with follicular lymphoma, after failing 2-5 lines of previous treatment, were subjected to radioimmunotherapy in three Polish Lymphoma Research Group (PLRG) centres. Ibritumomab infusion was followed by 2 doses of Rituximab (250 mg/m2 at day -7 and 0) to enhance its biodistribution. Radioimmunoconjugate was prepared in the Nuclear Medicine Departments of participating centres based on patient weight and full blood count results (14.8 MBq/kg, max 1200 MBq, reduced to 11.1 MBq/kg in cases with blood platelet 100 000-150 000 or leukocytes 1500-2000).
14.8 MBq/kg (0.4 mCi/kg)
100 thousand to 149 thousand/mm3 platelets
11.1 MBq/kg (0.3 mCi/kg)
RESULTS: The primary endpoint of the study was the assessment of response rate and haematological toxicity. Objective responses were observed in all patients, with 10 partial and 12 complete regressions. Cytopenia, starting 3-4 weeks after radioimmunotherapy, reflected haematological toxicity - the only important side effect. Thrombocytopenia was more pronounced, with platelet counts of < 50,000/ul in every second patient. One patient developed myelodysplastic syndrome 21 months after the procedure. After the medium time of follow up over 2 years, 2 patients died. Median progression free survival (secondary study endpoint) was 15 months.
CONCLUSIONS: Ibritumomab radioimmunotherapy is an efficient method of palliation treatment of heavily pre-treated follicular lymphoma patients, failing numerous previous treatment lines. Earlier application increases the number of complete responses and prolongs progression free survival.
Keywords
radioimmunotherapy; 90Y-ibritumomab tiuxetan (Zevalin); follicular lymphoma
About this articleTitle
Radioimmunotherapy in follicular lymphomas, a retrospective analysis of the Polish Lymphoma Research Group’s (PLRG) experience
Journal
Issue
Pages
91-97
Published online
2007-05-23
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523
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1120
Bibliographic record
Nucl. Med. Rev 2007;10(2):91-97.
Keywords
radioimmunotherapy
90Y-ibritumomab tiuxetan (Zevalin)
follicular lymphoma
Authors
Wojciech Jurczak
Alicja Hubalewska-Dydejczyk
Agnieszka Giza
Anna Sowa-Staszczak
Tomasz Wróbel
Grzegorz Mazur
Piotr Boguradzki
Wanda Knopińska-Posłuszny
Bohdan Huszno
Aleksander B. Skotnicki
