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Claimed association of absolute lymphocyte count with therapeutic efficacy of radio-immunotherapy in patients with indolent lymphoma cannot be verified in an independent data set

Leukemia volume 22, pages 2259–2260 (2008)Cite this article

We read with great interest the article by Porrata et al., suggesting that for patients with follicular lymphoma (FL), a higher absolute lymphocyte count (ALC) at the time of administration of 90Y-ibritumomab tiuxetan predicted both improved response and survival.1 The postulated mechanism for this relationship was that the higher ALC reflected ‘immune competence’, allowing improved antibody-dependent cellular cytotoxicity (ADCC) and complement-mediated lysis. Given their observation we analyzed our own institutional data of 131I-rituximab2 used for radio-immunotherapy (RIT) in patients with indolent B-cell non-Hodgkin lymphoma (NHL), to explore if the ALC predicted response, time to progression (TTP) and overall survival (OS). Treatment with a conjugated chimeric monoclonal antibody with a longer circulatory half-life, would be expected to have a greater degree of ADCC than the murine parent B1 antibody of ibritumomab, given the human-derived Fc portion of rituximab.3

Thirty-five consecutive patients with relapsed indolent NHL received 131I-rituximab between August 2000 and January 2008. Twenty-nine patients had been treated in the context of a multi-center phase II clinical trial, whose data has previously been published.2 The administered activity of the radio-immunotherapeutic dose was calculated to deliver an estimated whole-body radiation absorbed dose of 0.75 Gy as described previously.4 The ALC was obtained from automated full blood counts taken at a median of 4 days (range, 0–14) prior to the tracer dose of 131I-rituximab, which is given 7 days prior to the radio-immunotherapeutic dose.

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References

  1. Porrata LF, Ristow K, Witzig TE, Tuinistra N, Habermann TM, Inwards DJ et al. Absolute lymphocyte count predicts therapeutic efficacy and survival at the time of radioimmunotherapy in patients with relapsed follicular lymphomas. Leukemia 2007; 21: 2554–2556.

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  2. Leahy MF, Seymour JF, Hicks RJ, Turner JH . Multicenter phase II clinical study of iodine-131-rituximab radioimmunotherapy in relapsed or refractory indolent non-Hodgkin's lymphoma. J Clin Oncol 2006; 24: 4418–4425.

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  3. Maloney DG . Concepts in radiotherapy and immunotherapy: anti-CD20 mechanisms of action and targets. Semin Oncol 2005; 32 (1 Suppl 1): S19–S26.

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  4. Turner JH, Martindale AA, Boucek J, Claringbold PG, Leahy MF . 131I-Anti CD20 radioimmunotherapy of relapsed or refractory non-Hodgkins lymphoma: a phase II clinical trial of a nonmyeloablative dose regimen of chimeric rituximab radiolabeled in a hospital. Cancer Biother Radiopharm 2003; 18: 513–524.

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Authors and Affiliations

  1. Department of Haematology and Medical Oncology, Peter McCallum Cancer Centre, Melbourne, Australia

    M J Bishton, H M Prince, D S Ritchie, M Wolf & J F Seymour

  2. Department of Nuclear Medicine, Peter McCallum Cancer Centre, Melbourne, Australia

    R J Hicks

  3. University of Melbourne, Australia

    H M Prince & J F Seymour

Authors
  1. M J Bishton
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  2. R J Hicks
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  3. H M Prince
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  4. D S Ritchie
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  5. M Wolf
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  6. J F Seymour
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Correspondence to J F Seymour.

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Bishton, M., Hicks, R., Prince, H. et al. Claimed association of absolute lymphocyte count with therapeutic efficacy of radio-immunotherapy in patients with indolent lymphoma cannot be verified in an independent data set. Leukemia 22, 2259–2260 (2008). https://doi.org/10.1038/leu.2008.116

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