High-dose radioimmunotherapy versus conventional high-dose therapy and autologous hematopoietic stem cell transplantation for relapsed follicular non-Hodgkin lymphoma: a multivariable cohort analysis

Abstract

We performed a multivariable comparison of 125 consecutive patients with follicular lymphoma (FL) treated at our centers with either high-dose radioimmunotherapy (HD-RIT) using 131 I-anti-CD20 (n ‫؍‬ 27) or conventional high-dose therapy (C-HDT) (n ‫؍‬ 98) and autologous hematopoietic stem cell transplantation. estimated 5-year OS and PFS were 67% and 48%, respectively, for HD-RIT and 53% and 29%, respectively, for C-HDT. One hundred-day treatment-related mortality was 3.7% in the HD-RIT group and 11% in the C-HDT group. The probability of secondary myelodysplastic syndrome/ acute myeloid leukemia (MDS/AML) was estimated to be

Long-term event-free survivors after high-dose therapy and autologous stem-cell transplantation for low-grade follicular lymphoma

“…On the other hand, incorporation of targeted radiation approaches to ASCT, as with radioimmunoconjugates, has shown promise in phase I trials 22,23 and in a retrospective comparison. 24 In summary, high-dose therapy with stem-cell transplantation can result in long-term EFS and OS, even among patients with histologic transformation. In univariable and multivariable analyses, achievement of CR after ASCT is associated with prolonged EFS and OS suggesting that this approach may alter the course of the disease.…”

Radioimmunotherapy for B-cell lymphoma: Y90 ibritumomab tiuxetan and I131 tositumomab

“…Using multivariable analysis, patients with FL who had received high-dose I 131 tositumomab (n ¼ 27) were compared with those treated with an historical control population treated with conventional high-dose preparative regimens (n ¼ 98) (Gopal et al, 2003). The populations were generally well matched, although patients with a high IPI and elevated LDH were overrepresent in the RIT group.…”

Antibody-targeted radiation cancer therapy

“…Direct comparison between high-dose targeted radioimmunotherapy (HD-RIT) and conventional highdose radiotherapy (HD-XRT) has also been evaluated. A PFS of 48% and 29% with an OS of 67% and 53% for HD-RIT and HD-XRT, respectively, was reported 69 . Disappointingly, most patients receiving HD-RIT eventually relapsed, leading to the proposal of including chemotherapy in the radioimmunotherapy regimen 70,71 .…”

“…The CR rate, remission duration and the ORR from either single or fractionated doses of B-cell malignancies has been more impressive in clinical trials administering high myeloablative doses in conjunction with either autologous bone-marrow transplantation (BMT) or stem-cell transplantation (SCT) 60,[67][68][69][70] . This is significant, as it is often found that therapeutic doses of radioactivity delivered by an mAb cannot be administered without BMT or SCT support.…”