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Title: High-Dose [131I]Tositumomab (anti-CD20) Radioimmunotherapy and Autologous Hematopoietic Stem Cell Transplantation for Adults ≥ 60 Years Old with Relapsed or Refractory B-Cell Lymphoma

Abstract

Purpose: The majority of patients with relapsed or refractory B-cell, non-Hodgkin’s lymphoma (NHL) are over 60 years of age, yet they are often denied potentially curative high-dose therapy and autologous stem cell transplants (ASCT) due to the risk of excessive treatment-related morbidity and mortality. Myeloablative anti-CD20 radioimmunotherapy (RIT) can deliver curative radiation doses to tumor sites while limiting exposure to normal organs and may be particularly suited for older adults requiring high-dose therapy. Methods: Patients over age 60 with relapsed B-NHL received infusions of tositumomab anti-CD20 antibody labeled with 5-10mCi I-131 tracer for dosimetry purposes followed 10 days later by individualized therapeutic infusions of I-131-tositumomab (median 525 mCi, range 328-1154 mCi) to deliver 25-27Gy to the critical normal organ receiving the highest radiation dose. ASCT was performed approximately 2 weeks after therapy. Results: Twenty-four patients with a median age of 64 (range 60-76) who had received a median of four prior regimens (range 2-14) were treated. Thirteen (54%) had chemotherapy-resistant disease. The estimated 3-year overall and progression-free survivals were 59% and 51%, respectively with a median follow-up of 2.9 years (range 1-6 years). All patients experienced expected myeloablation with engraftment of platelets (≥20K/µL) and neutrophils (≥500/µL) occurring a median ofmore » 9 and 15 days, respectively following ASCT. There were no treatment-related deaths, and only two patients experienced grade 4 non-hematologic toxicity. Conclusions: Myeloablative RIT and ASCT is a safe and effective therapeutic option for older adults with relapsed B-NHL.« less

Authors:
; ; ; ; ; ; ; ; ;
Publication Date:
Research Org.:
Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
Sponsoring Org.:
USDOE
OSTI Identifier:
909996
Report Number(s):
PNNL-SA-51288
Journal ID: ISSN 0732-183X; JCONDN; 600306000; TRN: US0704064
DOE Contract Number:
AC05-76RL01830
Resource Type:
Journal Article
Resource Relation:
Journal Name: Journal of Clinical Oncology, 25(11):1396-1402; Journal Volume: 25; Journal Issue: 11
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADULTS; DISEASE INCIDENCE; DOSIMETRY; LYMPHOMAS; MORTALITY; NEOPLASMS; NEUTROPHILS; ORGANS; PATIENTS; RADIATION DOSES; RADIOIMMUNOTHERAPY; STEM CELLS; THERAPY; TOXICITY; TRANSPLANTS

Citation Formats

Gopal, Ajay K., Rajendran, Joseph G., Gooley, Ted, Pagel, John M., Fisher, Darrell R., Petersdorf, Stephen, Maloney, David G., Eary, Janet F., Appelbaum, Frederick R., and Press, Oliver W. High-Dose [131I]Tositumomab (anti-CD20) Radioimmunotherapy and Autologous Hematopoietic Stem Cell Transplantation for Adults ≥ 60 Years Old with Relapsed or Refractory B-Cell Lymphoma. United States: N. p., 2007. Web. doi:10.1200/JCO.2006.09.1215.
Gopal, Ajay K., Rajendran, Joseph G., Gooley, Ted, Pagel, John M., Fisher, Darrell R., Petersdorf, Stephen, Maloney, David G., Eary, Janet F., Appelbaum, Frederick R., & Press, Oliver W. High-Dose [131I]Tositumomab (anti-CD20) Radioimmunotherapy and Autologous Hematopoietic Stem Cell Transplantation for Adults ≥ 60 Years Old with Relapsed or Refractory B-Cell Lymphoma. United States. doi:10.1200/JCO.2006.09.1215.
Gopal, Ajay K., Rajendran, Joseph G., Gooley, Ted, Pagel, John M., Fisher, Darrell R., Petersdorf, Stephen, Maloney, David G., Eary, Janet F., Appelbaum, Frederick R., and Press, Oliver W. Tue . "High-Dose [131I]Tositumomab (anti-CD20) Radioimmunotherapy and Autologous Hematopoietic Stem Cell Transplantation for Adults ≥ 60 Years Old with Relapsed or Refractory B-Cell Lymphoma". United States. doi:10.1200/JCO.2006.09.1215.
@article{osti_909996,
title = {High-Dose [131I]Tositumomab (anti-CD20) Radioimmunotherapy and Autologous Hematopoietic Stem Cell Transplantation for Adults ≥ 60 Years Old with Relapsed or Refractory B-Cell Lymphoma},
author = {Gopal, Ajay K. and Rajendran, Joseph G. and Gooley, Ted and Pagel, John M. and Fisher, Darrell R. and Petersdorf, Stephen and Maloney, David G. and Eary, Janet F. and Appelbaum, Frederick R. and Press, Oliver W.},
abstractNote = {Purpose: The majority of patients with relapsed or refractory B-cell, non-Hodgkin’s lymphoma (NHL) are over 60 years of age, yet they are often denied potentially curative high-dose therapy and autologous stem cell transplants (ASCT) due to the risk of excessive treatment-related morbidity and mortality. Myeloablative anti-CD20 radioimmunotherapy (RIT) can deliver curative radiation doses to tumor sites while limiting exposure to normal organs and may be particularly suited for older adults requiring high-dose therapy. Methods: Patients over age 60 with relapsed B-NHL received infusions of tositumomab anti-CD20 antibody labeled with 5-10mCi I-131 tracer for dosimetry purposes followed 10 days later by individualized therapeutic infusions of I-131-tositumomab (median 525 mCi, range 328-1154 mCi) to deliver 25-27Gy to the critical normal organ receiving the highest radiation dose. ASCT was performed approximately 2 weeks after therapy. Results: Twenty-four patients with a median age of 64 (range 60-76) who had received a median of four prior regimens (range 2-14) were treated. Thirteen (54%) had chemotherapy-resistant disease. The estimated 3-year overall and progression-free survivals were 59% and 51%, respectively with a median follow-up of 2.9 years (range 1-6 years). All patients experienced expected myeloablation with engraftment of platelets (≥20K/µL) and neutrophils (≥500/µL) occurring a median of 9 and 15 days, respectively following ASCT. There were no treatment-related deaths, and only two patients experienced grade 4 non-hematologic toxicity. Conclusions: Myeloablative RIT and ASCT is a safe and effective therapeutic option for older adults with relapsed B-NHL.},
doi = {10.1200/JCO.2006.09.1215},
journal = {Journal of Clinical Oncology, 25(11):1396-1402},
number = 11,
volume = 25,
place = {United States},
year = {Tue Apr 10 00:00:00 EDT 2007},
month = {Tue Apr 10 00:00:00 EDT 2007}
}