TY - JOUR
T1 - Initial report of a phase II study with R-FND followed by ibritumomab tiuxetan radioimmunotherapy and rituximab maintenance in patients with untreated high-risk follicular lymphoma
AU - Samaniego, Felipe
AU - McLaughlin, Peter
AU - Neelapu, Sattva S.
AU - Feng, Lei
AU - Fanale, Michelle
AU - Nastoupil, Loretta
AU - Rodriguez, Maria Alma
AU - Pro, Barbara
AU - Taylor, Erin
AU - Hagemeister, Fredrick B.
AU - Fowler, Nathan
N1 - Publisher Copyright:
© 2020 The University of Texas MD Anderson Cancer Center.
PY - 2021
Y1 - 2021
N2 - R-FND (rituximab, fludarabine, mitoxantrone, and dexamethasone) can induce molecular remissions in indolent lymphoma. The addition of 90yttrium ibritumomab tiuxetan (90YIT) radioimmunotherapy following first-line induction treatment in patients with advanced follicular lymphoma (FL) may improve remission rates. We now report 10-year follow-up results from our sequential treatment approach with an abbreviated regimen of R-FND followed by 90YIT consolidation and rituximab maintenance. Forty-nine patients were enrolled; 47 received treatment. Patients had high-risk (FLIPI score ≥3) FL of grade 1–3A and stage III/IV with adequate hematologic function. Following R-FND, the complete and partial response rates were 91% and 8.5%, respectively. After 90YIT consolidation, the CR rate increased to 97%. The 10-year PFS rate was 49%. The most common non-hematologic, grade 3 or 4 adverse events were fatigue, dyspnea, and myalgia. Five developed myelodysplastic syndrome (MDS). This treatment approach is most appropriate in FLIPI-based high-risk patients whose outlook with standard therapy is inadequate.
AB - R-FND (rituximab, fludarabine, mitoxantrone, and dexamethasone) can induce molecular remissions in indolent lymphoma. The addition of 90yttrium ibritumomab tiuxetan (90YIT) radioimmunotherapy following first-line induction treatment in patients with advanced follicular lymphoma (FL) may improve remission rates. We now report 10-year follow-up results from our sequential treatment approach with an abbreviated regimen of R-FND followed by 90YIT consolidation and rituximab maintenance. Forty-nine patients were enrolled; 47 received treatment. Patients had high-risk (FLIPI score ≥3) FL of grade 1–3A and stage III/IV with adequate hematologic function. Following R-FND, the complete and partial response rates were 91% and 8.5%, respectively. After 90YIT consolidation, the CR rate increased to 97%. The 10-year PFS rate was 49%. The most common non-hematologic, grade 3 or 4 adverse events were fatigue, dyspnea, and myalgia. Five developed myelodysplastic syndrome (MDS). This treatment approach is most appropriate in FLIPI-based high-risk patients whose outlook with standard therapy is inadequate.
KW - B-cell lymphoma
KW - BCL2
KW - Fludarabine
KW - ibritumomab tiuxetan
KW - radioimmunotherapy
UR - http://www.scopus.com/inward/record.url?scp=85091029291&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091029291&partnerID=8YFLogxK
U2 - 10.1080/10428194.2020.1821005
DO - 10.1080/10428194.2020.1821005
M3 - Article
C2 - 32924687
AN - SCOPUS:85091029291
SN - 1042-8194
VL - 62
SP - 58
EP - 67
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 1
ER -