Jo Jae-Cheol, Yoon Dok Hyun, Kim Shin, Park Jung Sun, Park Chan-Sik, Huh Jooryung, Lee Sang-Wook, Ryu Jin-Sook, Suh Cheolwon
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Hematol. 2012 Jun;47(2):119-25. doi: 10.5045/kjh.2012.47.2.119. Epub 2012 Jun 26.
Radioimmunotherapy agents have a highly significant role in autologous stem cell transplantation as they improve tolerability and increase the efficacy of the conditioning regimen.
We retrospectively analyzed the efficacy and toxicity of yttrium-90 ibritumomab tiuxetan (Zevalin) combined with intravenous busulfan, cyclophosphamide, and etoposide (Z-BuCyE) compared with those of BuCyE alone followed by autologous stem cell transplantation in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (NHL). The efficacy, toxicity, and engraftment characteristics were compared between 19 patients who received Z-BuCyE and 19 historical controls who received BuCyE.
The 2 treatment groups shared similar baseline characteristics. The median time to platelet engraftment (>20×10(9)/L) and neutrophil engraftment (>0.5×10(9)/L) did not significantly differ between the Z-BuCyE group (12 days and 10 days, respectively) and the BuCyE group (12 days and 10 days, respectively). No significant differences were observed between the groups with respect to toxicities and treatment-related mortality. The median follow-up period was 30.4 months, and median event-free survival was generally better in the Z-BuCyE group (12.5 months) vs. the BuCyE group (6.2 months, P=0.236). No significant difference in overall survival between the groups was noted.
Adding ibritumomab tiuxetan to BuCyE high-dose chemotherapy may benefit patients with relapsed or refractory B-cell NHL with no risk of additional toxicity.
放射免疫治疗药物在自体干细胞移植中具有极其重要的作用,因为它们可提高耐受性并增强预处理方案的疗效。
我们回顾性分析了钇-90替伊莫单抗(泽瓦林)联合静脉注射白消安、环磷酰胺和依托泊苷(Z-BuCyE)与单独使用BuCyE随后进行自体干细胞移植相比,在复发或难治性B细胞非霍奇金淋巴瘤(NHL)患者中的疗效和毒性。比较了19例接受Z-BuCyE治疗的患者与19例接受BuCyE治疗的历史对照患者的疗效、毒性和植入特征。
两个治疗组具有相似的基线特征。Z-BuCyE组(分别为12天和10天)与BuCyE组(分别为12天和10天)之间,血小板植入(>20×10⁹/L)和中性粒细胞植入(>0.5×10⁹/L)的中位时间无显著差异。两组在毒性和治疗相关死亡率方面未观察到显著差异。中位随访期为30.4个月,Z-BuCyE组的中位无事件生存期(12.5个月)总体上优于BuCyE组(6.2个月,P=0.236)。两组之间的总生存期无显著差异。
在BuCyE大剂量化疗中添加替伊莫单抗可能使复发或难治性B细胞NHL患者受益,且无额外毒性风险。