Updated results of rituximab pre- and post-beam with or without90Yttrium ibritumomab tiuxetan during autologous transplant for diffuse large b-cell lymphoma

Jad Chahoud, Dawen Sui, William D. Erwin, Alison M. Gulbis, Martin Korbling, Mingzhi Zhang, Sairah Ahmed, Gheath Alatrash, Paolo Anderlini, Stefan O. Ciurea, Betul Oran, Luis E. Fayad, Roland L. Bassett, Elias J. Jabbour, L. Jeffrey Medeiros, Homer A. Macapinlac, Ken H. Young, Issa F. Khouri

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2304-2311
Number of pages8
JournalClinical Cancer Research
Volume24
Issue number10
DOIs
StatePublished - May 15 2018

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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