TY - JOUR
T1 - Nordic MCL3 study: Y-90-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 - Gronbaek, Kirsten
AU - Elonen, Erkki
AU - Raty, 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.
N1 - The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Pathology, (Lund) (013030000), Oncology, MV (013035000)
PY - 2014
Y1 - 2014
N2 - The main objective of the MCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90 Y-ibritumomab-tiuxetan (Zevalin) to the high-dose 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: the MCL2 trial with similar treatment except for Zevalin. Overall survival (OS), event-free survival (EFS), and progression-free survival (PFS) at 4 years were 78%, 62%, and 71%, respectively. For responding non-CR patients 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 and MRD were strong predictors of outcome. Intensification with Zevalin may be too late to improve the outcome of patients not in CR before transplant. This trial was registered at www.clinicaltrials.gov as #NCT00514475.
AB - The main objective of the MCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90 Y-ibritumomab-tiuxetan (Zevalin) to the high-dose 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: the MCL2 trial with similar treatment except for Zevalin. Overall survival (OS), event-free survival (EFS), and progression-free survival (PFS) at 4 years were 78%, 62%, and 71%, respectively. For responding non-CR patients 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 and MRD were strong predictors of outcome. Intensification with Zevalin may be too late to improve the outcome of patients not in CR before transplant. This trial was registered at www.clinicaltrials.gov as #NCT00514475.
U2 - 10.1182/blood-2013-12-541953
DO - 10.1182/blood-2013-12-541953
M3 - Article
C2 - 24652994
SN - 1528-0020
VL - 123
SP - 2953
EP - 2959
JO - Blood
JF - Blood
IS - 19
ER -