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Radioimmunotherapy with 90Y-ibritumomab tiuxetan is a safe and efficient treatment for patients with B-cell lymphoma relapsed after auto-SCT: an analysis of the international RIT-Network

Bone Marrow Transplantation volume 46, pages 901–903 (2011)Cite this article

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High-dose chemotherapy followed by Auto-SCT (ASCT) achieves prolonged disease-free survival in patients with relapsed or refractory non-Hodgkin's lymphoma. Relapse, however, remains the most common cause of treatment failure and death. Several trials had documented significant benefit from radioimmunotherapy (RIT) with yttrium-90 (90Y)-ibritumomab tiuxetan (Zevalin) or iodine-131 (131I)-tositumomab (Bexxar) for patients with relapsed follicular lymphoma (FL), leading to the approval of RIT as a treatment option for such patients.1, 2, 3, 4, 5 As to the marrow toxicity of RIT, patients with a history of ASCT had been excluded from most trials, resulting in only limited data on the safety and efficacy of RIT in patients with relapsed disease after ASCT.6, 7 However, a phase 1 clinical trial of Vose et al.5 recently documented the feasibility of RIT with ibritumomab tiuxetan up to dose levels of 0.2 mCi/kg, providing a rationale to offer RIT also to patients after ASCT. We here summarize retrospective data collected outside clinical trials from 109 patients treated with RIT for lymphoma relapsed after ASCT, as reported to the international RIT registry (RIT-NT).

The RIT-Network represents a Web-based, international registry that collects observational data from RIT-treated patients with malignant lymphoma. From December 2006 to November 2009, 1111 patients had been registered in the database. Of 105 patients who had received RIT after ASCT, the complete data sets of 70 patients were available for this analysis, predominantly treated with 90Y-ibritumomab tiuxetan (n=66). The study cohort comprised mainly patients with FL (n=48) and 22 patients with other B-cell malignancies (2 CLL, 7 diffuse large B-cell lymphoma, 6 mantle cell lymphoma, 2 marginal zone lymphoma, 1 ALL, 3 transformed follicular and 1 unspecified B-cell lymphoma). All patients had received several lines of prior chemotherapy including at least one high-dose protocol (Table 1), as well as prior radiotherapy in 40% of cases. Nine patients had undergone a previous RIT. In most patients (n=51) BM involvement had been excluded before RIT, whereas minor (<25%) and major (<25%) involvement had been documented in 12 and 2 patients, respectively. For seven patients BM status before RIT was not known. RIT was performed at a median interval of 698 days (range, 5–4435 days) after ASCT.

Table 1 Patients characteristics
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Authors and Affiliations

  1. Department of Hematology and Oncology, Georg August University, Göttingen, Germany

    K Hohloch, G G Wulf & L H Truemper

  2. Department of Hematology/Oncology, Istituto Seragnoli, University of Bologna, Bologna, Italy

    P L Zinzani

  3. Department of Hematology and Stem Cell Transplantation, Medical University of Graz, Graz, Austria

    W Linkesch

  4. Haematology/Oncology, University of Krakow, Krakow, Poland

    W Jurczak

  5. Haematology/Oncology, Central Hospital Warszawa, Warszawa, Poland

    A Deptala

  6. Alcedis GmbH, Giessen, Germany

    M Lorsbach & C Windemuth-Kiesselbach

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  1. K Hohloch
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  2. P L Zinzani
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Correspondence to K Hohloch.

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Hohloch, K., Zinzani, P., Linkesch, W. et al. Radioimmunotherapy with 90Y-ibritumomab tiuxetan is a safe and efficient treatment for patients with B-cell lymphoma relapsed after auto-SCT: an analysis of the international RIT-Network. Bone Marrow Transplant 46, 901–903 (2011). https://doi.org/10.1038/bmt.2010.202

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