Because of reports of anaplastic transformation following irradiation, this study examines the incidence of anaplastic transformation and local control of these lesions. This review of seven patients who had verrucous carcinoma of the head and neck that was treated with irradiation shows local control in 71% of cases. There were no cases of anaplastic transformation. This report adds to the literature two cases of "de-differentiation" to less differentiated squamous carcinomas; one such case occurred after surgery alone. The literature is reviewed. Overall, anaplastic transformation is reported in 7% of patients who had irradiation. De-differentiation occurs after surgery as well. The rate of local control with irradiation is less than 50%; with surgery it is 85%. It is concluded that surgery should be used if the procedure has acceptable morbidity. Otherwise, irradiation can be used. Failures can be salvaged surgically. "Anaplastic transformation" should not affect treatment approach.

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There is no data on safety and efficacy of a second course of ibritumomab tiuxetan. In this work, data on patients with B-cell NHL who were treated with two courses of ibritumomab tiuxetan were analyzed. Eighteen such patients were analyzed (age: 58 years, 48 - 91), with a median of four prior regimens (1 - 7), stem cell transplantation (n = 5), and radiation therapy (n = 6). After the first course, G3/4 neutropenia and thrombocytopenia was 35% and 41%; overall response rate (ORR) was 89%; time between courses was 16.6 months (6.0 - 42.7). After the second course, the incidence of G3/4 neutropenia and thrombocytopenia was 28% and 44%; and ORR 77%. There were no infectious or bleeding complications, secondary myelodysplastic syndromes, or leukemias. Retreatment with the ibritumomab tiuxetan regimen was well tolerated, with a safety profile similar to that of the first course. To conclude, patients who benefited from the first course of ibritumomab tiuxetan can benefit from retreatment.