Tsukamoto Norifumi, Yokohama Akihiko, Higuchi Tetsuya, Mitsui Takeki, Koiso Hiromi, Takizawa Makiko, Shimizu Hiroaki, Ishizaki Takuma, Matsumoto Morio, Toyama Kohtaro, Sakura Tohru, Ogura Hidemi, Saitoh Takayuki, Ishida Fumihiro, Murakami Hirokazu, Tsushima Yoshito, Handa Hiroshi
Oncology Center, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Int J Hematol. 2019 Jan;109(1):91-97. doi: 10.1007/s12185-018-2526-z. Epub 2018 Sep 10.
90Y-ibritumomab tiuxetan (90Y-IT) is widely used, but the factors responsible for its optimal treatment effects are unknown. We enrolled 34 patients with relapsed indolent lymphoma treated with 90Y-IT monotherapy at Gunma University Hospital between 2003 and 2014 in the present study. Clinical data including computed tomography and 18-Fluoro-deoxyglucose positron emission tomography were retrospectively analyzed. The overall response rate and complete response rate were 91% and 82%, respectively. The median progression-free survival (PFS) and overall survival were 32 months and not reached, respectively. In univariate analysis, tumor long-axis diameter ≤ 2.5 cm, maximum standardized uptake value (SUVmax) ≤ 6.5, localized disease, normal levels of serum soluble interleukin-2 receptor, and the number of involved nodal sites ≤ 3 immediately prior to 90Y-IT were associated with median PFS greater than 6 years. However, in multivariate analysis, only tumor long-axis diameter ≤ 2.5 cm and SUVmax ≤ 6.5 affected PFS [hazard ratio (HR) 0.130, P = 0.0021 and HR 0.283, P = 0.0311, respectively]. Patients with only one prior regimen needed less granulocyte colony-stimulating factor and platelet transfusion. Thus, 90Y-IT treatment should be considered for patients with indolent lymphoma in first relapse who have tumor long-axis diameter ≤ 2.5 cm and SUVmax ≤ 6.5.
钇90-替伊莫单抗（90Y-IT）被广泛应用，但其产生最佳治疗效果的相关因素尚不清楚。在本研究中，我们纳入了2003年至2014年间在群马大学医院接受90Y-IT单药治疗的34例复发性惰性淋巴瘤患者。对包括计算机断层扫描和18-氟脱氧葡萄糖正电子发射断层扫描在内的临床数据进行了回顾性分析。总缓解率和完全缓解率分别为91%和82%。中位无进展生存期（PFS）和总生存期分别为32个月和未达到。单因素分析中，肿瘤长径≤2.5 cm、最大标准化摄取值（SUVmax）≤6.5、局限性疾病、血清可溶性白细胞介素-2受体水平正常以及90Y-IT治疗前受累淋巴结部位数量≤3与中位PFS大于6年相关。然而，多因素分析中，只有肿瘤长径≤2.5 cm和SUVmax≤6.5影响PFS[风险比（HR）分别为0.130，P = 0.0021和HR 0.283，P = 0.0311]。仅接受过一种既往治疗方案的患者所需的粒细胞集落刺激因子和血小板输注较少。因此，对于首次复发且肿瘤长径≤2.5 cm和SUVmax≤6.5的惰性淋巴瘤患者，应考虑90Y-IT治疗。
