TY - JOUR
T1 - Dose-attenuated radioimmunotherapy with tositumomab and iodine 131 tositumomab in patients with recurrent non-Hodgkin's lymphoma (NHL) and extensive bone marrow involvement
AU - Mones, Jodi
AU - Coleman, Morton
AU - Kostakoglu, Lale
AU - Furman, Richard R.
AU - Chadburn, Amy
AU - Shore, Tsiporah B.
AU - Muss, Daniel
AU - Stewart, Patricia
AU - Kroll, Stewart
AU - Vallabhajosula, Shankar
AU - Goldsmith, Stanley J.
AU - Leonard, John P.
N1 - Funding Information:
This study was supported in part by a K23 award from the National Institutes of Health (RR16814), the Lymphoma Research Foundation, the Brian Rooney Fund of the Lymphoma Foundation, and Dorothy Rodbell Cohen Foundation for Cancer Research, as well as research support from Corixa Corporation. S.K. and P.S. are employees of Corixa Corporation.
PY - 2007/2
Y1 - 2007/2
N2 - Radioimmunotherapy (RIT) with tositumomab and iodine 131 tositumomab can produce durable and complete responses in relapsed/refractory low-grade Non-Hodgkin's lymphoma. Patients with bone marrow involvement (BMI) with tumor > 25% of the intertrabecular space are generally excluded from RIT because of risk of excessive hematologic toxicity. The authors conducted a dose-escalation study of tositumomab and iodine 131 tositumomab to determine whether RIT is feasible in this population. Patients had baseline BMI of >25% and platelet count of ≥150 000/ mm3. In contrast to the usual 75cGy total body dose of radiation, dose escalation of Iodine I 131 tositumomab began at a total body dose of 45 cGy, and increased to 55 cGy in a second cohort. Dose-limiting toxicity (DLT) was defined as absolute neutrophil count <500 cells/mm3 or platelets <25 000/mm3 for >17 days, or absolute neutrophil count <750/mm3 or platelets <50 000/mm3 for >24 days. Eleven subjects were enrolled (8 at 45 cGy and 3 at 55 cGy). Estimated BMI ranged from 30 to 65% (median approximately 40%). Patients had received a median of three prior chemotherapies (range 1-6). One of the six evaluable patients treated at 45 cGy experienced DLT. Three patients received 55 cGy, one had hematologic DLT concurrent with lymphoma progression and extensive BMI at relapse. Three of 11 (27%) patients received hematologic supportive care. Two patients had objective responses of 1 and 42.4+ months, respectively. RIT with attenuated dose iodine 131 tositumomab for patients with >25% BMI has acceptable toxicity and can result in lymphoma responses.
AB - Radioimmunotherapy (RIT) with tositumomab and iodine 131 tositumomab can produce durable and complete responses in relapsed/refractory low-grade Non-Hodgkin's lymphoma. Patients with bone marrow involvement (BMI) with tumor > 25% of the intertrabecular space are generally excluded from RIT because of risk of excessive hematologic toxicity. The authors conducted a dose-escalation study of tositumomab and iodine 131 tositumomab to determine whether RIT is feasible in this population. Patients had baseline BMI of >25% and platelet count of ≥150 000/ mm3. In contrast to the usual 75cGy total body dose of radiation, dose escalation of Iodine I 131 tositumomab began at a total body dose of 45 cGy, and increased to 55 cGy in a second cohort. Dose-limiting toxicity (DLT) was defined as absolute neutrophil count <500 cells/mm3 or platelets <25 000/mm3 for >17 days, or absolute neutrophil count <750/mm3 or platelets <50 000/mm3 for >24 days. Eleven subjects were enrolled (8 at 45 cGy and 3 at 55 cGy). Estimated BMI ranged from 30 to 65% (median approximately 40%). Patients had received a median of three prior chemotherapies (range 1-6). One of the six evaluable patients treated at 45 cGy experienced DLT. Three patients received 55 cGy, one had hematologic DLT concurrent with lymphoma progression and extensive BMI at relapse. Three of 11 (27%) patients received hematologic supportive care. Two patients had objective responses of 1 and 42.4+ months, respectively. RIT with attenuated dose iodine 131 tositumomab for patients with >25% BMI has acceptable toxicity and can result in lymphoma responses.
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U2 - 10.1080/10428190601059720
DO - 10.1080/10428190601059720
M3 - Article
C2 - 17325895
AN - SCOPUS:34247868279
SN - 1042-8194
VL - 48
SP - 342
EP - 348
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 2
ER -