Department of Haematology, Miguel Servet University Hospital, Zaragoza, Spain.
Ann Hematol. 2014 Dec;93(12):1985-92. doi: 10.1007/s00277-014-2145-6. Epub 2014 Jul 3.
The aim of this study was to analyze the outcomes of 37 follicular lymphoma (FL) patients treated with (90)ytrium ibritumomab tiuxetan (90Y-IT), outside of clinical trial, according to protocol ISCRTN36210045, after ≥5 years follow-up to February 2014. Health-related quality of life (HRQoL) was evaluated with the SF-36, Spanish version, and compared with the general population of Spain. Patients had a mean age of 61.9 (range, 30-85) years and included 18 males. FLIPI, low: 25 (67.6 %), intermedium 9 (24.3 %), and low 3 (8.1 %). Previous therapy schedules >2: 48.6 % The median follow-up was 66 months, mean Time to Relapse (TTR) 71.3 months (58.8-83.8) median not reached. Thirty-four patients achieved complete response (91.8 %), and three no response. Mean overall survival: 82.3 months (71.6-92.9). Four patients presented with concomitant tumors (colon, breast, prostate, lung) after radioimmunotherapy, and three developed second primary neoplasms (esophagus, renal, and myelodysplastic syndrome in a relapsed patient who received fludarabine). Four of 10 deaths were related to lymphoma progression. Hematological toxicities were mild and easily managed. No patients required hospitalization. Negative scores were obtained in the physical and emotional roles items; however, the perception of general health and vitality were better than in the general population, with the best outcomes in non-relapsed patients. Radioimmunotherapy with 90Y-IT was safe and effective as long-term therapy in patients with FL. Early use of radioimmunotherapy could offer good, sustained responses with low toxicity over the long term and acceptable HRQoL.
本研究旨在分析 37 例滤泡性淋巴瘤 (FL) 患者在≥5 年随访至 2014 年 2 月后，根据 ISCRTN36210045 方案，采用 90 钇替伊莫单抗替昔妥珠单抗（90Y-IT）进行治疗的结果。采用西班牙版 SF-36 评估健康相关生活质量（HRQoL），并与西班牙普通人群进行比较。患者平均年龄为 61.9 岁（范围 30-85 岁），包括 18 名男性。FLIPI 低危：25 例（67.6%），中危 9 例（24.3%），低危 3 例（8.1%）。先前的治疗方案>2：48.6%。中位随访时间为 66 个月，中位复发时间（TTR）为 71.3 个月（58.8-83.8），中位未达到。34 例患者达到完全缓解（91.8%），3 例无反应。平均总生存期：82.3 个月（71.6-92.9）。4 例患者在放射免疫治疗后同时发生肿瘤（结肠、乳腺、前列腺、肺），3 例发生第二原发肿瘤（食管、肾、复发患者骨髓增生异常综合征接受氟达拉滨治疗）。10 例死亡中有 4 例与淋巴瘤进展有关。血液学毒性较轻，易于处理。无患者需要住院。身体角色和情绪角色项目获得负分；然而，一般健康和活力的感知优于普通人群，无复发患者的结果最佳。90Y-IT 放射免疫治疗作为 FL 的长期治疗是安全有效的。早期使用放射免疫治疗可以提供良好、持续的反应，长期毒性低，生活质量可接受。
