Long term efficacy and safety of Fludarabine, Cyclophosphamide and Rituximab regimen followed by90Y-ibritumomab tiuxetan consolidation for the treatment of relapsed grades 1 and 2 follicular lymphoma

Experimental Hematology & Oncology

Mirella Marino⁴  Francesco Marchesi³  Sandra Rea²  Ramy Kayal⁵  Diana Giannarelli⁶  Maria Laura Dessanti¹  Rosa Sciuto²  Francesco Pisani³ 

[1] Unit of Hematology and Stem Cell Transplant Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy;Department of Nuclear Medicine Regina Elena National Cancer Institute, Rome, Italy;Department of Hematology Regina Elena National Cancer Institute, Via Elio Chianesi, Rome, 53 - 00144, Italy;Department of Pathology Regina Elena National Cancer Institute, Rome, Italy;Department of Radiology Regina Elena National Cancer Institute, Rome, Italy;Biostatistics Regina Elena National Cancer Institute, Rome, Italy

关键词: Radioimmunotherapy;    90Y-ibritumomab tiuxetan;    Follicular lymphoma;   

Others  :  1220362
DOI  :  10.1186/s40164-015-0012-3

 received in 2015-03-20, accepted in 2015-06-17,  发布年份 2015

【 摘 要 】

Background

In this retrospective study, we investigated the efficacy and safety of radioimmunotherapy with⁹⁰ Yttrium- ibritumomab tiuxetan ( ⁹⁰ Y-RIT) in 9 patients with recurrent follicular lymphoma (FL) who were treated in a consolidation setting after having achieved complete (CR) or partial remission (PR) with Fludarabine, Cyclophosphamide and Rituximab (FCR).

Methods

The median age was 63 years (range 46–77). All patients were relapsed with histologically confirmed CD20-positive (grade 1 or 2) FL, at relapse they received FCR every 28 days: F (25 mg/m ² x 3 days), C (1 gr/m ²  day 1) and R (375 mg/m ²  day 4) for 4 cycles. Those who achieved at least a PR with <25 % bone marrow involvement were treated with⁹⁰ Y-RIT 11.1 or 14.8 MBq/Kg, at 3 months after completing FCR. Patients underwent a further restaging at 12 weeks after⁹⁰ Y-RIT with a total body CT scan, FDG-PET/CT and bilateral bone marrow biopsy.

Results

Nine patients completed the treatment: FCR followed by⁹⁰ Y-RIT (6 patients at 14.8 MBq/Kg, 3 patients at 11.1 MBq/Kg). After FCR, 7 patients obtained CR and 2 PR; after⁹⁰ Y-RIT 2 patients in PR converted to CR 12 weeks later. With a median follow up of 95 months (range 20–114) since FCR and 88 months (range 13–104) since⁹⁰ Y-RIT 3 deaths were not related to lymphoma; all 3 deceased patients obtained CR before⁹⁰ Y-RIT and died still in CR. The median overall (OS) and progression free survival (PFS) have not been reached, in this analysis both OS or PFS are 67 % at 7.5 year. The most common grade 3 or 4 adverse events were hematologic.

Conclusions

These results confirm the long term efficacy and safety of 4 cycles of FCR followed by⁹⁰ Y-RIT in relapsed grades 1 and 2 FL and suggest that this regimen could be a therapeutic option for this setting of patients, specially at age of 60–75 with no unexpected toxicities.

【 授权许可】

   
2015 Pisani et al.

【 图 表 】

Fig. 1.

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