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Clinical Trial
. 2012 Jun 28;119(26):6373-8.
doi: 10.1182/blood-2012-03-417808. Epub 2012 May 14.

Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results

Issa F Khouri  1 , Rima M Saliba, William D Erwin, Barry I Samuels, Martin Korbling, L Jeffrey Medeiros, Rosamar Valverde, Amin M Alousi, Paolo Anderlini, Qaiser Bashir, Stefan Ciurea, Alison M Gulbis, Marcos de Lima, Chitra Hosing, Partow Kebriaei, Uday R Popat, Nathan Fowler, Sattva S Neelapu, Felipe Samaniego, Richard E Champlin, Homer A Macapinlac
Affiliations
Clinical Trial

Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results

Issa F Khouri et al. Blood. .

Abstract

In 2008, we reported favorable 5-year outcomes of nonmyeloablative allogeneic stem cell transplantation after fludarabine, cyclophosphamide, rituximab (FCR) conditioning for relapsed and chemosensitive follicular lymphoma. However, innovative strategies were still needed to treat patients with chemorefractory disease. We therefore subsequently performed a trial in which (90)Y-ibritumomab tiuxetan (0.4 mCi/kg) was added to the fludarabine, cyclophosphamide conditioning regimen ((90)YFC). Here, we report updated results of the FCR trial and outcomes after (90)YFC. For the FCR group (N = 47), since the last update, one patient developed recurrent disease. With a median follow-up of 107 months (range, 72-142 months), the 11-year overall survival and progression-free survival rates were 78%, and 72%, respectively. For the (90)YFC group (N = 26), more patients had chemorefractory disease than did those in the FCR group (38% and 0%, P < .001). With a median follow-up of 33 months (range,17-94 months), the 3-year progression-free survival rates for patients with chemorefractory and chemosensitive disease were 80% and 87%, respectively (P = .7). The low frequency of relapse observed after a long follow-up interval of 9 years in the FCR group suggests that these patients are cured of their disease. The addition of (90)Y to the conditioning regimen appears to be effective in patients with chemorefractory disease. This trial was registered at www.clinicaltrials.gov as NCT00048737.

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Figures

Figure 1
Figure 1
Treatment schema of 90Y-ibritumomab tiuxetan, fludarabine (30 mg/m2 per day), and cyclophosphamide (750 mg/m2 per day; 90YFC).
Figure 2
Figure 2
OS and PFS rates after NST with FCR conditioning.
Figure 3
Figure 3
OS and PFS rates after NST with 90YFC conditioning.
Figure 4
Figure 4
PFS rates after FCR and 90YFC conditioning in patients with chemosensitive and chemorefractory disease.
Figure 5
Figure 5
PFS rates after FCR or 90YFC, according to PET status at study entry.
See this image and copyright information in PMC

References

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    1. Khouri IF, McLaughlin P, Saliba RM, et al. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008;111(12):5530–5536. - PMC - PubMed

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