Autologous stem cell transplantation after conditioning with yttrium-90 ibritumomab tiuxetan BEAM in refractory non-Hodgkin diffuse large B-cell lymphoma: results of a prospective, multicenter, phase II clinical trial

Briones, Javier; Novelli, Silvana; García-Marco, José A.; Tomás, José Francisco; Bernal, Teresa; Grande, Carlos; Canales, Miguel; Torres, Aurora Feliú; Moraleda, José Marı́a; Panizo, Carlos; Jarque, Isidro; Palmero, Francisca; Hernández, Miguel T.; González‐Barca, Eva; López, Dulce; Caballero, Dolores

doi:10.3324/haematol.2014.108308

Cited by 7 publications

(3 citation statements)

References 2 publications

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“…One major focus has been the addition of radioimmunotherapy as part of the conditioning regimen for transplantation. Multiple phase 1 and 2 studies using either 131 I-tositumomab or 90 Y-ibritumomab tiuxetan combined with chemotherapy have yielded very promising results (Press et al, 2000;Krishnan et al, 2008;Winter et al, 2009;Decaudin et al, 2011;Shimoni et al, 2012;Vose et al, 2013a;Briones et al, 2014). However, a phase 3 study comparing rituximab/BEAM versus 131 I-tositumomab/BEAM (Vose et al, 2013b) showed no benefit from adding this radioimmunotherapy to BEAM in patients with chemotherapy-sensitive relapsed DLBCL.…”

Section: Discussionmentioning

confidence: 99%

Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma: a phase 2 study from the GELTAMO group

Redondo

Valcárcel²,

González-Rodríguez

et al. 2018

Br J Haematol

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Summary We conducted a phase 2 trial to evaluate the safety and efficacy of bendamustine instead of BCNU (carmustine) in the BEAM (BCNU, etoposide, cytarabine and melphalan) regimen (BendaEAM) as conditioning for autologous stem‐cell transplantation (ASCT) in patients with aggressive lymphomas. The primary endpoint was 3‐year progression‐free survival (PFS). Sixty patients (median age 55 [28–71] years) were included. All patients (except one who died early) engrafted after a median of 11 (9–72) and 14 (4–53) days to achieve neutrophil and platelet counts of >0.5 × 109/l and >20 × 109/l, respectively. Non‐relapse mortality at 100 days and 1 year were 3.3% and 6.7%, respectively. With a median follow‐up of 67 (40–77) months, the estimated 3‐year PFS and overall survival (OS) were 58% and 75%, respectively. Patients in partial response at study entry had significantly worse PFS and OS than patients who underwent ASCT in complete metabolic remission, and this was the only prognostic factor associated with both PFS (Relative risk [RR], 0.27 [95% confidence interval {CI} [0.12–0.56]) and OS (RR, 0.40 [95% CI 0.17–0.97]) in the multivariate analysis. BendaEAM conditioning is therefore a feasible and effective regimen in patients with aggressive lymphomas. However, patients not in complete metabolic remission at the time of transplant had poorer survival and so should be considered for alternative treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma: a phase 2 study from the GELTAMO group

Redondo

Valcárcel²,

González-Rodríguez

et al. 2018

Br J Haematol

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“…21,22 Radioimmunotherapy (RIT) is a targeted approach for delivery of RT that has been shown to be safe and effective as a treatment for non-Hodgkin lymphoma (NHL) and has been incorporated into AHCT conditioning regimens. [23][24][25][26][27][28][29][30][31][32][33][34] CD25 is the interleukin-2 receptor α-subunit (IL-2αR) and is expressed on Reed-Sternberg (RS) cells and lymphocytes in the surrounding tumor microenvironment in HL. There have been several RIT trials evaluating radio-labeled antibodies directed against CD25 in patients with lymphoma, including HL, which have demonstrated tolerability and anti-tumor activity.…”

Section: Introductionmentioning

confidence: 99%

Anti-CD25 radioimmunotherapy with BEAM autologous hematopoietic cell transplantation conditioning in Hodgkin lymphoma

Herrera

Palmer

Adhikarla³

et al. 2021

Blood Advances

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High-risk relapsed or refractory (R/R) classical Hodgkin lymphoma (HL) is associated with poor outcomes after conventional salvage therapy and autologous hematopoietic cell transplantation (AHCT). Post-AHCT consolidation with brentuximab vedotin (BV) improves progression-free survival (PFS), but with increasing use of BV early in the treatment course, the utility of consolidation is unclear. CD25 is often expressed on Reed-Sternberg cells and in the tumor microenvironment in HL and we hypothesized that the addition of 90Y-antiCD25 (aTac) to BEAM AHCT would be safe and result in a transplantation platform that is agnostic to prior HL-directed therapy. Twenty-five patients with high-risk R/R HL were enrolled onto this phase 1 dose-escalation trial of aTac-BEAM. Following an imaging dose of 111In-antiCD25, 2 patients had altered biodistribution and a third developed an unrelated catheter-associated bacteremia; therefore 22 patients ultimately received therapeutic 90Y-aTac-BEAM AHCT. No dose-limiting toxicities were observed and 0.6mCi/kg was deemed the recommended phase 2 dose, the dose at which the heart wall would not receive > 2500cGy. Toxicities and time to engraftment were similar to those observed with standard AHCT, though 95% of patients developed stomatitis (all grade 1-2 per Bearman toxicity scale). Seven relapses (32%) were observed, most commonly in patients with 3 or more risk factors. The estimated 5-year PFS and overall survival probabilities among 22 evaluable patients were 68% and 95%, respectively, and non-relapse mortality was 0%. aTac-BEAM AHCT was tolerable in patients with high-risk R/R HL and we are further evaluating the efficacy of this approach in a phase 2 trial. The clinical trial was registered at clinicaltrials.gov (NCT01476839).

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“…The role of RIT as part of a conditioning regimen before ASCT has been studied in patients with diffuse large-B cell lymphoma (DLBCL) or FL [14][15][16][17], but its role in MCL patients is poorly studied so far. Incorporating RIT into a conditioning regimen prior to autologous stem cell transplantation in MCL patients might further enhance eradication of residual disease after induction therapy and ultimately prolong PFS and OS [18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Zevalin and BEAM (Z‐BEAM) versus rituximab and BEAM (R‐BEAM) conditioning chemotherapy prior to autologous stem cell transplantation in patients with mantle cell lymphoma

Berger

Branger

Klaeser

et al. 2015

Hematological Oncology

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Early relapse is common in patients with mantle cell lymphoma (MCL) highlighting the unmet need for further improvement of therapeutic options for these patients. CD20 inhibition combined with induction chemotherapy as well as consolidation with high-dose chemotherapy (HDCT) is increasingly considered cornerstones within current therapy algorithms of MCL whereas the role of radioimmunotherapy is unclear. This retrospective single center study compared 46 consecutive MCL patients receiving HDCT in first or second remission. Thirty-five patients had rituximab and BEAM (R-BEAM), and 11 patients received ibritumomab tiuxetan (Zevalin®), an Yttrium-90 labeled CD20 targeting antibody, prior to BEAM (Z-BEAM) followed by autologous stem cell transplantation (ASCT). We observed that the 5-year overall survival (OS) in the R-BEAM and Z-BEAM groups was 55% and 71% (p = 0.288), and the 4-year progression free survival (PFS) was 32% and 41%, respectively (p = 0.300). There were no treatment related deaths in both groups, and we observed no differences in toxicities, infection rates or engraftment. Our data suggest that the Z-BEAM conditioning regimen followed by ASCT is well tolerated, but was not associated with significantly improved survival compared to R-BEAM. Copyright © 2015 John Wiley & Sons, Ltd.

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Autologous stem cell transplantation after conditioning with yttrium-90 ibritumomab tiuxetan BEAM in refractory non-Hodgkin diffuse large B-cell lymphoma: results of a prospective, multicenter, phase II clinical trial

Cited by 7 publications

References 2 publications

Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma: a phase 2 study from the GELTAMO group

Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma: a phase 2 study from the GELTAMO group

Anti-CD25 radioimmunotherapy with BEAM autologous hematopoietic cell transplantation conditioning in Hodgkin lymphoma

Zevalin and BEAM (Z‐BEAM) versus rituximab and BEAM (R‐BEAM) conditioning chemotherapy prior to autologous stem cell transplantation in patients with mantle cell lymphoma

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