Open AccessOutcomes after 90 Yttrium‐ibritumomab tiuxetan‐BEAM in diffuse large B‐cell lymphoma: a meta‐analysis
Author(s) -
AugerQuittet Sophie,
Duny Yohan,
Daures JeanPierre,
Quittet Philipe
Publication year - 2014
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.247
Subject(s) - yttrium , diffuse large b cell lymphoma , nuclear medicine , ibritumomab tiuxetan , medicine , lymphoma , meta analysis , radioimmunotherapy , materials science , antibody , immunology , monoclonal antibody , metallurgy , oxide
High‐dose chemotherapy followed by autologous stem cell transplantation ( ASCT ) is a standard therapy in patients with relapsed/refractory diffuse large B‐cell lymphoma ( DLBCL ) who are chemosensitive. The combination of carmustine, etoposide, cytarabine, and melphalan ( BEAM ) is commonly used as a conditioning regimen. The addition of yttrium‐90 ( 90 Y)‐ibritumomab tiuxetan (Zevalin ® ) to BEAM (Z‐ BEAM ) is increasingly being used to improve outcomes and overcome refractory disease. We conducted a literature review and meta‐analysis in order to evaluate the clinical effects of Z‐ BEAM followed by ASCT in patients with DLBCL . A literature search was conducted for randomized controlled trials and observational studies of Z‐ BEAM as a conditioning regimen for ASCT in adult patients with DLBCL . Extracted data included baseline patient demographics, overall response ( ORR ), complete response ( CR ), overall survival ( OS ), progression‐free survival ( PFS ), nonrelapse mortality ( NRM ), median time to ANC and platelet engraftment, and rate of myelodysplastic syndrome. Mixed‐effects models were used to determine estimates. Ten studies ( N = 328) were included in the meta‐analysis. The 2‐year OS and PFS were 84.5% ( n = 328) and 67.2% ( n = 285), respectively. Outcomes were superior in patients with nontransformed lymphoma. Posttransplant, ORR and CR rates were 72.6% and 68.5%, respectively. The NRM rate was 6.3% and the incidence rate of myelodysplastic syndrome was 2.5%. Two‐year OS was significantly associated with pretransplant ORR ( P = 0.008, τ 2 = 0). There was no significant association between PFS and pretransplant response. Z‐ BEAM is safe and effective as a conditioning regimen in relapsed/refractory DLBCL .