Radiation dosimetry results from a phase II trial of Ibritumomab Tiuxetan (Zevalin™) radioimmunotherapy for patients with non-Hodgkin's lymphoma and mild thrombocytopenia

This was a 30-patient Phase II trial of reduced-dose ⁹⁰Y ibritumomab tiuxetan (Zevalin™) RIT for patients with low-grade, follicular, or transformed B-cell NHL and mild thrombocytopenia. Patients were given an imaging dose of ¹¹¹In-labeled ibritumomab tiuxetan for dosimetry measurements. One week later, patients were administered a therapeutic dose of O.3 mCi/kg (11 MBq/kg) ⁹⁰Y ibritumomab tiuxetan. Both ¹¹¹In- and ⁹⁰Y-labeled ibritumomab tiuxetan doses were preceded by an infusion of 250 mg/m² rituximab (Rituxan®, MabThera®) an unlabeled chimeric anti-CD20 antibody, to clear peripheral blood B cells and improve biodistribution of the radiolabeled antibody. For all 30 patients, normal organ and red marrow radiation absorbed doses were well below protocol-defined limits of 2000 cGy and 300 cGy, respectively. Median radiation absorbed doses were 48 cGy to red marrow (range: 6.5-95 cGy), 393 cGy to liver (range: 92-1581 cGy), 522 cGy to spleen (range: 165-1711 cGy), 162 cGy to lungs (41-295 cGy), and 14 cGy to kidneys (0.03-65 cGy). Though most correlative analyses were negative, certain analyses demonstrated a statistically significant correlation between the severity or duration of thrombocytopenia and pharmacokinetic or dosimetric parameters. These correlations were not consistent across the total patient population, and therefore, could not be exploited to predict hematologic toxicity.