PMID- 27677906
OWN - NLM
STAT- MEDLINE
DCOM- 20180112
LR  - 20180112
IS  - 1099-1069 (Electronic)
IS  - 0278-0232 (Linking)
VI  - 35
IP  - 4
DP  - 2017 Dec
TI  - Y(90) -Ibritumomab tiuxetan (Y(90) -IT) and high-dose melphalan as conditioning 
      regimen before autologous stem cell transplantation for elderly patients with 
      lymphoma in relapse or resistant to chemotherapy: a feasibility trial (SAKK 
      37/05).
PG  - 576-583
LID - 10.1002/hon.2348 [doi]
AB  - Standard conditioning regimens for autologous stem cell transplantation (ASCT) 
      are often not tolerated by elderly patients, on one hand. Single high-dose 
      melphalan, on the other hand, has been shown to be safe and active as a 
      pretransplant preparative regimen in elderly patients. Y(90) -Ibritumomab 
      tiuxetan (Y(90) -IT) is well tolerated and feasible in the transplantation 
      setting. We therefore investigated the combination of high-dose melphalan and 
      Y(90) -IT as a conditioning regimen for patients >/=65 years of age. Patients with 
      relapsed or resistant CD20-positive lymphoma in remission after salvage 
      chemotherapy could be enrolled. High-dose therapy consisted of standard dose 
      Y(90) -IT (0.4-mCi/kg body weight) followed by melphalan at escalating doses 
      (100, 140, 170 and 200 mg/m(2) ) and ASCT. The primary objective was to identify 
      the maximum tolerated dose; secondary end points were complete response (CR) rate 
      100 days after transplantation and toxicity. Twenty patients (median age 
      72 years) were included. No DLT occurred at any dose level. Thirteen patients 
      completed the treatment, 11 were evaluable for response. Seven patients did not 
      complete treatment because of mobilization failure (n = 3), progressive disease 
      (n = 2), worsening of cardiac function (n = 1), and grade 3 dyspnea (n = 1). 
      Seven patients achieved a CR/complete remission/unconfirmed (CRu) and 2 had 
      stable disease. Five out of 7 responding patients were still alive more than 
      3 years after transplantation. The 2 patients with SD had a long-term survival of 
      3 and 5 years, respectively. Nonhematological grade 3 or higher treatment related 
      adverse events (AEs) were infection (n = 6), including 2 cases of febrile 
      neutropenia, diarrhea (n = 3), mucositis, anorexia, viral hepatitis, hypokalemia, 
      dehydration, and multiorgan failure (n = 1 for each). The combination of Y(90) 
      -IT and high-dose melphalan is feasible before ASCT for elderly patients, with 
      promising activity and manageable toxicity.
CI  - Copyright (c) 2016 John Wiley & Sons, Ltd.
FAU - Voegeli, Michele
AU  - Voegeli M
AD  - Medizinische Universitatsklinik, Liestal, Switzerland.
FAU - Rondeau, Stephanie
AU  - Rondeau S
AD  - SAKK Coordinating Center, Bern, Switzerland.
FAU - Berardi Vilei, Simona
AU  - Berardi Vilei S
AD  - SAKK Coordinating Center, Bern, Switzerland.
FAU - Lerch, Erika
AU  - Lerch E
AD  - Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
FAU - Wannesson, Luciano
AU  - Wannesson L
AD  - Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
FAU - Pabst, Thomas
AU  - Pabst T
AD  - Inselspital Bern, Bern, Switzerland.
FAU - Rentschler, Jochen
AU  - Rentschler J
AD  - Universitatsspital Basel, Basel, Switzerland.
AD  - Ortenau Klinikum Offenburg, Offenburg, Germany.
FAU - Bargetzi, Mario
AU  - Bargetzi M
AD  - Kantonsspital Aarau, Aarau, Switzerland.
FAU - Jost, Lorenz
AU  - Jost L
AD  - Kantonsspital Bruderholz, Bruderholz, Switzerland.
FAU - Ketterer, Nicolas
AU  - Ketterer N
AD  - CHUV, Lausanne, Switzerland.
AD  - Hirslanden Lausanne SA, Lausanne, Switzerland.
FAU - Bischof Delaloye, Angelika
AU  - Bischof Delaloye A
AD  - CHUV, Lausanne, Switzerland.
FAU - Ghielmini, Michele
AU  - Ghielmini M
AD  - Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
LA  - eng
PT  - Clinical Trial, Phase I
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160928
PL  - England
TA  - Hematol Oncol
JT  - Hematological oncology
JID - 8307268
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Yttrium Radioisotopes)
RN  - 4Q52C550XK (ibritumomab tiuxetan)
RN  - Q41OR9510P (Melphalan)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Monoclonal/administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Drug Resistance, Neoplasm
MH  - Female
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Humans
MH  - Lymphoma/mortality/*pathology/*therapy
MH  - Male
MH  - Melphalan/administration & dosage
MH  - Neoplasm Grading
MH  - Recurrence
MH  - Retreatment
MH  - Time Factors
MH  - *Transplantation Conditioning/adverse effects/methods
MH  - Transplantation, Autologous
MH  - Treatment Outcome
MH  - Yttrium Radioisotopes
OTO - NOTNLM
OT  - Y90-Ibritumomab tiuxetan
OT  - autologous stem cell transplantation
OT  - high-dose melphalan
OT  - recurrent lymphoma
EDAT- 2016/09/30 06:00
MHDA- 2018/01/13 06:00
CRDT- 2016/09/29 06:00
PHST- 2016/05/29 00:00 [received]
PHST- 2016/07/24 00:00 [revised]
PHST- 2016/08/01 00:00 [accepted]
PHST- 2016/09/30 06:00 [pubmed]
PHST- 2018/01/13 06:00 [medline]
PHST- 2016/09/29 06:00 [entrez]
AID - 10.1002/hon.2348 [doi]
PST - ppublish
SO  - Hematol Oncol. 2017 Dec;35(4):576-583. doi: 10.1002/hon.2348. Epub 2016 Sep 28.