1. Initial report of a phase II study with R-FND followed by ibritumomab tiuxetan radioimmunotherapy and rituximab maintenance in patients with untreated high-risk follicular lymphoma.
- Author
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Samaniego F, McLaughlin P, Neelapu SS, Feng L, Fanale M, Nastoupil L, Rodriguez MA, Pro B, Taylor E, Hagemeister FB, and Fowler N
- Subjects
- Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols adverse effects, Humans, Rituximab therapeutic use, Treatment Outcome, Yttrium Radioisotopes therapeutic use, Lymphoma, Follicular drug therapy, Lymphoma, Follicular therapy, Radioimmunotherapy
- Abstract
R-FND (rituximab, fludarabine, mitoxantrone, and dexamethasone) can induce molecular remissions in indolent lymphoma. The addition of
90 yttrium ibritumomab tiuxetan (90 YIT) radioimmunotherapy following first-line induction treatment in patients with advanced follicular lymphoma (FL) may improve remission rates. We now report 10-year follow-up results from our sequential treatment approach with an abbreviated regimen of R-FND followed by90 YIT consolidation and rituximab maintenance. Forty-nine patients were enrolled; 47 received treatment. Patients had high-risk (FLIPI score ≥3) FL of grade 1-3A and stage III/IV with adequate hematologic function. Following R-FND, the complete and partial response rates were 91% and 8.5%, respectively. After90 YIT consolidation, the CR rate increased to 97%. The 10-year PFS rate was 49%. The most common non-hematologic, grade 3 or 4 adverse events were fatigue, dyspnea, and myalgia. Five developed myelodysplastic syndrome (MDS). This treatment approach is most appropriate in FLIPI-based high-risk patients whose outlook with standard therapy is inadequate.- Published
- 2021
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