TY - JOUR
T1 - Updated results of rituximab pre- and post-beam with or without90Yttrium ibritumomab tiuxetan during autologous transplant for diffuse large b-cell lymphoma
AU - Chahoud, Jad
AU - Sui, Dawen
AU - Erwin, William D.
AU - Gulbis, Alison M.
AU - Korbling, Martin
AU - Zhang, Mingzhi
AU - Ahmed, Sairah
AU - Alatrash, Gheath
AU - Anderlini, Paolo
AU - Ciurea, Stefan O.
AU - Oran, Betul
AU - Fayad, Luis E.
AU - Bassett, Roland L.
AU - Jabbour, Elias J.
AU - Jeffrey Medeiros, L.
AU - Macapinlac, Homer A.
AU - Young, Ken H.
AU - Khouri, Issa F.
N1 - Publisher Copyright:
© 2018 American Association for Cancer Research.
PY - 2018/5/15
Y1 - 2018/5/15
N2 - Purpose: We evaluated the effect on long-term survival of adding rituximab (R) to BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning with or without yttrium-90 ibritumomab tiuxetan (90YIT) in patients with relapsed diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (ASCT). Experimental design: Patients were enrolled on three consecutive phase II clinical trials. Patients received two doses of rituximab (375 and 1,000 mg/m2) during mobilization of stem cells, followed by 1,000 mg/m2 on days þ1 and þ8 after ASCT with R-BEAM or 90YIT-R-BEAM (90YIT dose of 0.4 mCi/kg) conditioning. Results: One hundred thirteen patients were enrolled, with 73 receiving R-BEAM and 40 receiving 90YIT-R-BEAM. All patients had a prior exposure to rituximab. The median follow-up intervals for survivors were 11.8, 8.1, and 4.2 years in the three trials, respectively. The 5-year disease-free survival (DFS) rates were 62% for R-BEAM and 65% for 90YIT-R-BEAM (P ¼ 0.82). The 5-year overall survival rates were 73% and 77%, respectively (P ¼ 0.65). In patients with de novo DLBCL, survival outcomes of the germinal center/activated b-cell histologic subtypes were similar with 5-year OS rates (P ¼ 0.52) and DFS rates (P ¼ 0.64), irrespective of their time of relapse (<1 vs. >1 year) after initial induction chemotherapy (P ¼ 0.97). Conclusions: Administering ASCT with rituximab during stem cell collection and immediately after transplantation induces long-term disease remission and abolishes the negative prognostic impact of cell-of-origin in patients with relapsed DLBCL. The addition of 90YIT does not confer a further survival benefit.
AB - Purpose: We evaluated the effect on long-term survival of adding rituximab (R) to BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning with or without yttrium-90 ibritumomab tiuxetan (90YIT) in patients with relapsed diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (ASCT). Experimental design: Patients were enrolled on three consecutive phase II clinical trials. Patients received two doses of rituximab (375 and 1,000 mg/m2) during mobilization of stem cells, followed by 1,000 mg/m2 on days þ1 and þ8 after ASCT with R-BEAM or 90YIT-R-BEAM (90YIT dose of 0.4 mCi/kg) conditioning. Results: One hundred thirteen patients were enrolled, with 73 receiving R-BEAM and 40 receiving 90YIT-R-BEAM. All patients had a prior exposure to rituximab. The median follow-up intervals for survivors were 11.8, 8.1, and 4.2 years in the three trials, respectively. The 5-year disease-free survival (DFS) rates were 62% for R-BEAM and 65% for 90YIT-R-BEAM (P ¼ 0.82). The 5-year overall survival rates were 73% and 77%, respectively (P ¼ 0.65). In patients with de novo DLBCL, survival outcomes of the germinal center/activated b-cell histologic subtypes were similar with 5-year OS rates (P ¼ 0.52) and DFS rates (P ¼ 0.64), irrespective of their time of relapse (<1 vs. >1 year) after initial induction chemotherapy (P ¼ 0.97). Conclusions: Administering ASCT with rituximab during stem cell collection and immediately after transplantation induces long-term disease remission and abolishes the negative prognostic impact of cell-of-origin in patients with relapsed DLBCL. The addition of 90YIT does not confer a further survival benefit.
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U2 - 10.1158/1078-0432.CCR-17-3561
DO - 10.1158/1078-0432.CCR-17-3561
M3 - Article
C2 - 29476021
AN - SCOPUS:85047837483
SN - 1078-0432
VL - 24
SP - 2304
EP - 2311
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 10
ER -