Abstract
90YIT is approved for the treatment of relapsed follicular lymphoma or as consolidation therapy after first line chemotherapy. Its role as therapy for the front line treatment of early stage B cell indolent lymphoma is under investigation.
Thirty-one patients with B cell lymphoma: grade 1 or 2 follicular lymphoma [FL], or marginal zone lymphoma (MZL) with stages I or II were enrolled for treatment with Zevalin (90yttrium-ibritumomab-tiuxetan [90YIT]). Patients received 90YIT according to standard procedure. Primary end points were overall response rates and progression-free survival. Initial evaluation included CT scans, PET-CT, CBC and bone marrow biopsies. Assessment of response was made at 4 months, and monitored every 3, 6 and 12 months during year 1, 2 and 3 of follow up, respectively. CBC was analyzed every 2 weeks until recovery of counts. Median and range for quantitative, absolute and relative frequencies for categorical variables were calculated. PFS was estimated by using Kaplan-Meier method.
Twenty-one patients had FL and 10 had MZL. The median age was 57 years (range 28-87) with 6/31 (19%) having bulky lymphoma (greater than 5 cm diameter). The overall response rate was 100% with CR 87% and Cru 13% with a median follow up of 56 months for the censored observations. The median progression free survival time has not been reached. 10 patients relapsed; 8/20 (40%) with FL and 2/11 (18%) with MZL. The rate of relapses was 33% in bulky and 32% in nonbulky lymphoma. Adverse events were primarily hematologic; the incidence of grade 3 and 4 neutropenia, thrombocytopenia, and anemia were 45% and 16%, 19% and 16% and 0% and 3%, respectively. Non-hematologic toxicity never exceeded grade 2 according to CTCAE v3.0.
90YIT is well-tolerated and has achieved high response rates in patients with early stage B cell indolent lymphoma. Bulky disease did not adversely affect tumor responses.
Pro:Spectrum: Honoraria.
Author notes
Asterisk with author names denotes non-ASH members.
