Micallef Ivana N M
Mayo Clinic College of Medicine, Rochester, MN, USA.
Clin Lymphoma. 2004 Oct;5 Suppl 1:S27-32. doi: 10.3816/clm.2004.s.006.
Targeted radiation therapy or radioimmunotherapy has been an important recent advance in the treatment of patients with B-cell non-Hodgkin's lymphoma (NHL). Yttrium 90-labeled ibritumomab tiuxetan (Zevalin) comprises the murine monoclonal antibody ibritumomab, the linker chelator tiuxetan, and the radiolabeled isotope yttrium 90. Yttrium 90 ibritumomab tiuxetan has been shown to be efficacious in the treatment of B-cell NHL. Initial phase I/II trials established the therapeutic dose of ibritumomab tiuxetan for low-grade NHL to be 0.4 mCi/kg, or 0.3 mCi/kg for patients with mild thrombocytopenia. Currently, there are many ongoing trials of ibritumomab tiuxetan with different dose schedules and dose intensities in combination with chemotherapy and autologous or allogeneic stem cell transplantation in an attempt to improve response rate and duration and to study its effectiveness in other B-cell lymphomas including mantle cell lymphoma, and chronic lymphocytic leukemia. This article reviews the ongoing trials with 90Y ibritumomab tiuxetan. Radioimmunotherapy has great promise, and the safe incorporation of 90Y ibritumomab tiuxetan into treatment will hopefully result in improved survival for patients with NHL.
靶向放射治疗或放射免疫治疗是近年来B细胞非霍奇金淋巴瘤(NHL)患者治疗方面的一项重要进展。钇90标记的替伊莫单抗(泽瓦林)由鼠源单克隆抗体替伊莫单抗、连接螯合剂替克他肽和放射性标记同位素钇90组成。钇90替伊莫单抗已被证明对B细胞NHL的治疗有效。最初的I/II期试验确定,低级别NHL患者替伊莫单抗的治疗剂量为0.4 mCi/kg,轻度血小板减少患者为0.3 mCi/kg。目前,有许多正在进行的关于替伊莫单抗的试验,采用不同的剂量方案和剂量强度,与化疗以及自体或异基因干细胞移植联合使用,试图提高缓解率和缓解持续时间,并研究其在包括套细胞淋巴瘤和慢性淋巴细胞白血病在内的其他B细胞淋巴瘤中的有效性。本文综述了正在进行的钇90替伊莫单抗试验。放射免疫治疗前景广阔,将钇90替伊莫单抗安全地纳入治疗有望提高NHL患者的生存率。