Abbreviated chemotherapy with fludarabine followed by tositumomab and iodine I 131 tositumomab for untreated follicular lymphoma. Academic Article uri icon

Overview

MeSH

  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Vidarabine

MeSH Major

  • Antibodies, Monoclonal
  • Antineoplastic Combined Chemotherapy Protocols
  • Lymphoma, Follicular
  • Radioimmunotherapy

abstract

  • To evaluate the safety and efficacy of a sequential chemotherapy plus radioimmunotherapy (RIT) regimen in previously untreated follicular non-Hodgkin's lymphoma. Thirty-five patients received an abbreviated course (three cycles) of fludarabine followed 6 to 8 weeks later by tositumomab and iodine I 131 tositumomab. After fludarabine, 31 (89%) of 35 patients responded, with three (9%) of 31 patients achieving a complete response (CR). After the full regimen of fludarabine and iodine I 131 tositumomab, all 35 patients responded; 30 (86%) of 35 patients achieved CR, and five (14%) of 35 achieved partial response. After a median follow-up of 58 months, the median progression-free survival (PFS) had not been reached (95% CI, 27 months to not reached), but it will be at least 48 months. The 5-year estimated PFS rate is 60%. Baseline Follicular Lymphoma International Prognostic Index (FLIPI) was significantly associated (P = .003) with PFS. Five of six patients with more than 25% bone marrow involvement at baseline achieved adequate bone marrow cytoreduction to receive standard-dose iodine I 131 tositumomab. Ten (77%) of 13 patients with baseline bone marrow Bcl-2 positivity demonstrated molecular remissions at month 12. Toxicities were manageable and principally hematologic. Two (6%) of 35 patients developed human antimurine antibodies (HAMA) after RIT. Use of abbreviated fludarabine before iodine I 131 tositumomab can reduce bone marrow involvement, when needed, to allow the use of RIT and can suppress HAMA responses. This sequential treatment regimen is highly effective as front-line therapy for follicular lymphoma, particularly for low- or intermediate-risk FLIPI patients.

publication date

  • August 20, 2005

has subject area

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal
  • Antineoplastic Combined Chemotherapy Protocols
  • Combined Modality Therapy
  • Female
  • Humans
  • Lymphoma, Follicular
  • Male
  • Middle Aged
  • Prospective Studies
  • Radioimmunotherapy
  • Treatment Outcome
  • Vidarabine

Research

keywords

  • Clinical Trial
  • Clinical Trial, Phase II
  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1200/JCO.2005.14.803

PubMed ID

  • 16110029

Additional Document Info

start page

  • 5696

end page

  • 5704

volume

  • 23

number

  • 24