Yttrium-90 Ibritumomab Tiuxetan is Cost-Effective Compared to Bendamustine + Rituximab in Low-grade Lymphomas

Muhamad Alhaj Moustafa, Bijan J. Borah, James P. Moriarty, Ruchita Dholakia, Liuyan Jiang, Ke Li, Thomas Elmer Witzig, Bradford S. Hoppe, Jennifer Peterson, James R. Cerhan, Han W. Tun

Research output: Contribution to journalArticlepeer-review


Background: Yttrium-90 ibritumomab tiuxetan [(90)Y-IT] is a CD20-targeted radio-immunotherapeutic agent. It has shown an excellent therapeutic activity with high tolerability against previously untreated follicular lymphoma (FL) and marginal zone B cell lymphoma (MZL). It is an attractive therapeutic option as the treatment schedule is short and convenient. The aim of our study is to determine the cost-effectiveness of (90)Y-IT in comparison to the standard-of-care bendamustine + rituximab (BR) in the first-line treatment of low-grade FL (LG-FL) and MZL in the real world. Patients and Methods: We included all patients who were treated with standard-dose (90)Y-IT for previously untreated LG-FL and MZL at the Mayo Clinic Cancer Center (N = 51). A comparator arm with a historical cohort of previously untreated LG-FL and MZL patients who received BR was used (N = 92). Results: Inverse propensity weighting was utilized to balance the 2 study arms. There were no differences in terms of overall response rate (100% vs. 98%, P =. 18), complete response rate (94% vs. 95%, P =. 91), or 5 years progression-free survival (76% vs. 75%, P =. 63) between patients who received (90)Y-IT and BR, respectively. Within the first year, patients who received (90)Y-IT required an average of 4.5 fewer oncology clinic visits (P <. 001), an average of 10 fewer days of therapeutic use (P <. 001), and 40% less use of growth factors (P <. 001) as compared to the BR group. The direct therapeutic cost of (90)Y-IT treatment was 54% less than that of 6 cycles of BR. Conclusion: The findings suggest that (90) Y-IT is more cost-effective than BR and is a viable alternative in up-front management of LG-FL and MZL.

Original languageEnglish (US)
Pages (from-to)259-265
Number of pages7
JournalClinical Lymphoma, Myeloma and Leukemia
Issue number4
StatePublished - Apr 2023


  • Cost-effectiveness
  • Follicular lymphoma
  • Marginal zone lymphoma
  • Previously untreated
  • Radioimmunotherapy
  • Zevalin

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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