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High activity 90 Y‐ibritumomab tiuxetan (Zevalin ® ) with peripheral blood progenitor cells support in patients with refractory/resistant B‐cell non‐Hodgkin lymphomas
Author(s) -
Ferrucci Pier F.,
Vanazzi Anna,
Grana Chiara M.,
Cremonesi Marta,
Bartolomei Mirco,
Chinol Marco,
Ferrari Mahila,
Radice Davide,
Papi Stefano,
Martinelli Giovanni,
Paganelli Giovanni
Publication year - 2007
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2007.06869.x
Subject(s) - medicine , ibritumomab tiuxetan , radioimmunotherapy , toxicity , autologous stem cell transplantation , refractory (planetary science) , gastroenterology , nuclear medicine , lymphoma , immunology , antibody , physics , monoclonal antibody , astrobiology
Summary Radioimmunotherapy (RIT) is an alternative approach in the treatment of resistant/refractory B‐cell non‐Hodgkin lymphoma (NHL). We performed a feasibility and toxicity pilot study of escalating activity of 90 Y‐ibritumomab tiuxetan followed by autologous stem cell transplantation (ASCT). Three activity levels were fixed – 30 MBq/kg (0·8 mCi/kg), 45 MBq/kg (1·2 mCi/kg) and 56 MBq/kg (1·5 mCi/kg) – and 13 patients enrolled. One week before treatment all patients underwent dosimetry. ASCT was performed 13 d after Zevalin ® administration. Treatment was well tolerated and all patients engrafted promptly. No differences in terms of haematological toxicities were observed among the three levels, apart from a delayed platelet recovery in heavily pretreated patients receiving 56 MBq/kg. Non‐haematologic toxicity was mainly related to infections and liver toxicity. One patient died 4 months after treatment because of hepatitis C virus reactivation. One patient developed a myelodysplastic syndrome 2 years after treatment. In conclusion, high‐activity Zevalin ® with ASCT is feasible and could be safely delivered in elderly and heavily pretreated NHL patients, including those who previously received high‐dose chemotherapy and ASCT. Maximum tolerated dose was not clearly defined according to dosimetry and clinical toxicities, and further studies are needed to confirm the toxicity profile and evaluate efficacy.