Nordic MCL3 study: 90Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma

Arne Kolstad; Anna Laurell; Mats Jerkeman; Kirsten Grønbæk; Erkki Elonen; Riikka Räty; Lone Bredo Pedersen; Annika Loft; Trond Velde Bogsrud; Eva Kimby; Per Boye Hansen; Unn-Merete Fagerli; Herman Nilsson-Ehle; Grete Fossum Lauritzsen; Anne Kristine Lehmann; Christer Sundstrom; Marja-Liisa Karjalainen-Lindsberg; Elisabeth Ralfkiaer; Mats Ehinger; Jan Delabie; Hans Bentzen; Jukka Schildt; Kamelia Kostova-Aherdan; Henrik Frederiksen; Peter de Nully Brown; Christian H Geisler; Nordic Lymphoma Group

doi:10.1182/blood-2013-12-541953

Nordic MCL3 study: ⁹⁰Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma

Arne Kolstad, Anna Laurell, Mats Jerkeman, Kirsten Grønbæk, Erkki Elonen, Riikka Räty, Lone Bredo Pedersen, Annika Loft, Trond Velde Bogsrud, Eva Kimby, Per Boye Hansen, Unn-Merete Fagerli, Herman Nilsson-Ehle, Grete Fossum Lauritzsen, Anne Kristine Lehmann, Christer Sundstrom, Marja-Liisa Karjalainen-Lindsberg, Elisabeth Ralfkiaer, Mats Ehinger, Jan DelabieHans Bentzen, Jukka Schildt, Kamelia Kostova-Aherdan, Henrik Frederiksen, Peter de Nully Brown, Christian H Geisler, Nordic Lymphoma Group

Institut for Klinisk Medicin

68 Citationer (Scopus)

Abstract

The main objective of theMCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding ⁹⁰Y- ibritumomab-tiuxetan (Zevalin) to the highdose regimen. One hundred sixty untreated, stage II-IV mantle cell lymphoma patients <66 years received rituximab (R)-maxi-CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) alternating with R-high-dose cytarabine (6 cycles total), followed by high-dose BEAM/C (bis-chloroethylnitrosourea, etoposide, cytarabine, and melphalan or cyclophosphamide) and autologous stem cell transplantation from 2005 to 2009. Zevalin (0.4 mCi/kg) was given to responders not in CR before transplant. Overall response rate pretransplant was 97%. The outcome did not differ from that of the historic control: theMCL2 trial with similar treatment except for Zevalin.Overall survival (OS), eventfree survival (EFS), and progression-free survival (PFS) at 4 yearswere 78%, 62%, and 71%, respectively.For responding non-CRpatients who received Zevalin, duration of response was shorter than for the CR group. Inferior PFS, EFS, and OS were predicted by positron emission tomography (PET) positivity pretransplant and detectable minimal residual disease (MRD) after transplant. In conclusion, positive PET andMRD were strong predictors of outcome. Intensificationwith Zevalin may be too late to improve the outcomeof patients not in CR before transplant.

Originalsprog	Engelsk
Tidsskrift	Blood
Vol/bind	123
Udgave nummer	19
Sider (fra-til)	2953 - 2959
Antal sider	7
ISSN	0006-4971
DOI	https://doi.org/10.1182/blood-2013-12-541953
Status	Udgivet - 8 maj 2014

Adgang til dokumentet

10.1182/blood-2013-12-541953

Citationsformater

Kolstad, A., Laurell, A., Jerkeman, M., Grønbæk, K., Elonen, E., Räty, R., Pedersen, L. B., Loft, A., Bogsrud, T. V., Kimby, E., Hansen, P. B., Fagerli, U-M., Nilsson-Ehle, H., Lauritzsen, G. F., Lehmann, A. K., Sundstrom, C., Karjalainen-Lindsberg, M-L., Ralfkiaer, E., Ehinger, M., ... Nordic Lymphoma Group (2014). Nordic MCL3 study: ⁹⁰Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma. Blood, 123(19), 2953 - 2959. https://doi.org/10.1182/blood-2013-12-541953

Kolstad, A, Laurell, A, Jerkeman, M, Grønbæk, K, Elonen, E, Räty, R, Pedersen, LB, Loft, A, Bogsrud, TV, Kimby, E, Hansen, PB, Fagerli, U-M, Nilsson-Ehle, H, Lauritzsen, GF, Lehmann, AK, Sundstrom, C, Karjalainen-Lindsberg, M-L, Ralfkiaer, E, Ehinger, M, Delabie, J, Bentzen, H, Schildt, J, Kostova-Aherdan, K, Frederiksen, H, Brown, PDN, Geisler, CH & Nordic Lymphoma Group 2014, 'Nordic MCL3 study: ⁹⁰Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma', Blood, bind 123, nr. 19, s. 2953 - 2959. https://doi.org/10.1182/blood-2013-12-541953

@article{6d7f3b48d8b8440eac3d33fcf5616286,

title = "Nordic MCL3 study: 90Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma",

abstract = "The main objective of theMCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90Y- ibritumomab-tiuxetan (Zevalin) to the highdose regimen. One hundred sixty untreated, stage II-IV mantle cell lymphoma patients <66 years received rituximab (R)-maxi-CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) alternating with R-high-dose cytarabine (6 cycles total), followed by high-dose BEAM/C (bis-chloroethylnitrosourea, etoposide, cytarabine, and melphalan or cyclophosphamide) and autologous stem cell transplantation from 2005 to 2009. Zevalin (0.4 mCi/kg) was given to responders not in CR before transplant. Overall response rate pretransplant was 97%. The outcome did not differ from that of the historic control: theMCL2 trial with similar treatment except for Zevalin.Overall survival (OS), eventfree survival (EFS), and progression-free survival (PFS) at 4 yearswere 78%, 62%, and 71%, respectively.For responding non-CRpatients who received Zevalin, duration of response was shorter than for the CR group. Inferior PFS, EFS, and OS were predicted by positron emission tomography (PET) positivity pretransplant and detectable minimal residual disease (MRD) after transplant. In conclusion, positive PET andMRD were strong predictors of outcome. Intensificationwith Zevalin may be too late to improve the outcomeof patients not in CR before transplant.",

keywords = "Adult, Aged, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Carmustine, Combined Modality Therapy, Cyclophosphamide, Cytarabine, Disease-Free Survival, Etoposide, Female, Humans, Kaplan-Meier Estimate, Lymphoma, Mantle-Cell, Male, Melphalan, Middle Aged, Multivariate Analysis, Neoplasm, Residual, Prognosis, Radioimmunotherapy, Stem Cell Transplantation, Time Factors, Transplantation, Autologous, Treatment Outcome",

author = "Arne Kolstad and Anna Laurell and Mats Jerkeman and Kirsten Gr{\o}nb{\ae}k and Erkki Elonen and Riikka R{\"a}ty and Pedersen, {Lone Bredo} and Annika Loft and Bogsrud, {Trond Velde} and Eva Kimby and Hansen, {Per Boye} and Unn-Merete Fagerli and Herman Nilsson-Ehle and Lauritzsen, {Grete Fossum} and Lehmann, {Anne Kristine} and Christer Sundstrom and Marja-Liisa Karjalainen-Lindsberg and Elisabeth Ralfkiaer and Mats Ehinger and Jan Delabie and Hans Bentzen and Jukka Schildt and Kamelia Kostova-Aherdan and Henrik Frederiksen and Brown, {Peter de Nully} and Geisler, {Christian H} and {Nordic Lymphoma Group}",

year = "2014",

month = may,

day = "8",

doi = "10.1182/blood-2013-12-541953",

language = "English",

volume = "123",

pages = "2953 -- 2959",

journal = "Blood",

issn = "0006-4971",

publisher = "American Society of Hematology",

number = "19",

}

TY - JOUR

T1 - Nordic MCL3 study: 90Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma

AU - Kolstad, Arne

AU - Laurell, Anna

AU - Jerkeman, Mats

AU - Grønbæk, Kirsten

AU - Elonen, Erkki

AU - Räty, Riikka

AU - Pedersen, Lone Bredo

AU - Loft, Annika

AU - Bogsrud, Trond Velde

AU - Kimby, Eva

AU - Hansen, Per Boye

AU - Fagerli, Unn-Merete

AU - Nilsson-Ehle, Herman

AU - Lauritzsen, Grete Fossum

AU - Lehmann, Anne Kristine

AU - Sundstrom, Christer

AU - Karjalainen-Lindsberg, Marja-Liisa

AU - Ralfkiaer, Elisabeth

AU - Ehinger, Mats

AU - Delabie, Jan

AU - Bentzen, Hans

AU - Schildt, Jukka

AU - Kostova-Aherdan, Kamelia

AU - Frederiksen, Henrik

AU - Brown, Peter de Nully

AU - Geisler, Christian H

AU - Nordic Lymphoma Group

PY - 2014/5/8

Y1 - 2014/5/8

N2 - The main objective of theMCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90Y- ibritumomab-tiuxetan (Zevalin) to the highdose regimen. One hundred sixty untreated, stage II-IV mantle cell lymphoma patients <66 years received rituximab (R)-maxi-CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) alternating with R-high-dose cytarabine (6 cycles total), followed by high-dose BEAM/C (bis-chloroethylnitrosourea, etoposide, cytarabine, and melphalan or cyclophosphamide) and autologous stem cell transplantation from 2005 to 2009. Zevalin (0.4 mCi/kg) was given to responders not in CR before transplant. Overall response rate pretransplant was 97%. The outcome did not differ from that of the historic control: theMCL2 trial with similar treatment except for Zevalin.Overall survival (OS), eventfree survival (EFS), and progression-free survival (PFS) at 4 yearswere 78%, 62%, and 71%, respectively.For responding non-CRpatients who received Zevalin, duration of response was shorter than for the CR group. Inferior PFS, EFS, and OS were predicted by positron emission tomography (PET) positivity pretransplant and detectable minimal residual disease (MRD) after transplant. In conclusion, positive PET andMRD were strong predictors of outcome. Intensificationwith Zevalin may be too late to improve the outcomeof patients not in CR before transplant.

AB - The main objective of theMCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90Y- ibritumomab-tiuxetan (Zevalin) to the highdose regimen. One hundred sixty untreated, stage II-IV mantle cell lymphoma patients <66 years received rituximab (R)-maxi-CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) alternating with R-high-dose cytarabine (6 cycles total), followed by high-dose BEAM/C (bis-chloroethylnitrosourea, etoposide, cytarabine, and melphalan or cyclophosphamide) and autologous stem cell transplantation from 2005 to 2009. Zevalin (0.4 mCi/kg) was given to responders not in CR before transplant. Overall response rate pretransplant was 97%. The outcome did not differ from that of the historic control: theMCL2 trial with similar treatment except for Zevalin.Overall survival (OS), eventfree survival (EFS), and progression-free survival (PFS) at 4 yearswere 78%, 62%, and 71%, respectively.For responding non-CRpatients who received Zevalin, duration of response was shorter than for the CR group. Inferior PFS, EFS, and OS were predicted by positron emission tomography (PET) positivity pretransplant and detectable minimal residual disease (MRD) after transplant. In conclusion, positive PET andMRD were strong predictors of outcome. Intensificationwith Zevalin may be too late to improve the outcomeof patients not in CR before transplant.

KW - Adult

KW - Aged

KW - Antibodies, Monoclonal

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Carmustine

KW - Combined Modality Therapy

KW - Cyclophosphamide

KW - Cytarabine

KW - Disease-Free Survival

KW - Etoposide

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Lymphoma, Mantle-Cell

KW - Male

KW - Melphalan

KW - Middle Aged

KW - Multivariate Analysis

KW - Neoplasm, Residual

KW - Prognosis

KW - Radioimmunotherapy

KW - Stem Cell Transplantation

KW - Time Factors

KW - Transplantation, Autologous

KW - Treatment Outcome

U2 - 10.1182/blood-2013-12-541953

DO - 10.1182/blood-2013-12-541953

M3 - Journal article

C2 - 24652994

SN - 0006-4971

VL - 123

SP - 2953

EP - 2959

JO - Blood

JF - Blood

IS - 19

ER -

Nordic MCL3 study: 90Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma

Abstract

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Citationsformater

Nordic MCL3 study: ⁹⁰Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma