TY - JOUR
T1 - Treatment recommendations for radioimmunotherapy in follicular lymphoma
T2 - A consensus conference report
AU - Witzig, Thomas E.
AU - Fishkin, Paul
AU - Gordon, Leo I.
AU - Gregory, Stephanie A.
AU - Jacobs, Samuel
AU - MacKlis, Roger
AU - McLaughlin, Peter
AU - Press, Oliver
AU - Zelenetz, Andrew D.
PY - 2011/7
Y1 - 2011/7
N2 - Radioimmunotherapy (RIT) with 90Y-ibritumomab tiuxetan or 131I-tositumomab combines a radiation-emitting radionuclide with an antibody targeting CD20 to treat B-cell non-Hodgkin lymphoma. Multiple studies demonstrate favorable RIT efficacy and safety profiles in follicular lymphoma (FL). The primary toxicity is reversible myelosuppression. Various FL treatment options include single-agent immunotherapy, radiation, chemoimmunotherapy, and RIT. Examining RIT clinical effects and position within treatment algorithms is important to optimal patient benefit. Clinical studies support using single-agent RIT in relapsed/refractory FL, in selected patients with new, untreated FL, and as consolidation after induction chemotherapy or chemoimmunotherapy. RIT as consolidation enhances response rates (with conversion of partial to complete responses following induction therapy) and prolongs disease control versus observation. The overall response rate is 60-80% in the relapsed setting. Time to progression is longer with low-bulk disease, fewer prior therapies, and retained rituximab sensitivity. RIT apparently does not preclude subsequent therapies or increase risk of secondary malignancies compared with chemotherapy's known risk. This article summarizes consensus recommendations for RIT and presents RIT treatment algorithms developed by hematologists/oncologists who regularly treat patients with FL. Maximizing RIT benefit requires healthcare providers to utilize algorithms assisting with treatment decisions.
AB - Radioimmunotherapy (RIT) with 90Y-ibritumomab tiuxetan or 131I-tositumomab combines a radiation-emitting radionuclide with an antibody targeting CD20 to treat B-cell non-Hodgkin lymphoma. Multiple studies demonstrate favorable RIT efficacy and safety profiles in follicular lymphoma (FL). The primary toxicity is reversible myelosuppression. Various FL treatment options include single-agent immunotherapy, radiation, chemoimmunotherapy, and RIT. Examining RIT clinical effects and position within treatment algorithms is important to optimal patient benefit. Clinical studies support using single-agent RIT in relapsed/refractory FL, in selected patients with new, untreated FL, and as consolidation after induction chemotherapy or chemoimmunotherapy. RIT as consolidation enhances response rates (with conversion of partial to complete responses following induction therapy) and prolongs disease control versus observation. The overall response rate is 60-80% in the relapsed setting. Time to progression is longer with low-bulk disease, fewer prior therapies, and retained rituximab sensitivity. RIT apparently does not preclude subsequent therapies or increase risk of secondary malignancies compared with chemotherapy's known risk. This article summarizes consensus recommendations for RIT and presents RIT treatment algorithms developed by hematologists/oncologists who regularly treat patients with FL. Maximizing RIT benefit requires healthcare providers to utilize algorithms assisting with treatment decisions.
KW - Follicular lymphoma
KW - I-tositumomab
KW - Y-ibritumomab tiuxetan
KW - non-Hodgkin lymphoma
KW - radioimmunotherapy
KW - treatment algorithm
UR - http://www.scopus.com/inward/record.url?scp=79959576404&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79959576404&partnerID=8YFLogxK
U2 - 10.3109/10428194.2011.570396
DO - 10.3109/10428194.2011.570396
M3 - Review article
C2 - 21599576
AN - SCOPUS:79959576404
SN - 1042-8194
VL - 52
SP - 1188
EP - 1199
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 7
ER -