Objective: Treatment-related complications are more common in older patients with non-Hodgkin's lymphoma (NHL), often leading to chemotherapy modifications that can compromise efficacy. We analyzed data from clinical trials of yttrium-90-ibritumomab tiuxetan (Zevalin); Biogen Idec, Cambridge, MA) to determine its safety and efficacy in older patients with NHL.
Design and methods: Data on safety and efficacy from four clinical trials of (90)Y-ibritumomab tiuxetan in 211 patients with NHL were pooled and analyzed by ages of <60, 60-69, and > or =70 years.
Results: Patients > or =70 years had a similar incidence of grade 3 or 4 neutropenia (68% vs. 66%), thrombocytopenia (68% vs. 70%), anemia (8% vs. 22%), and nonhematologic adverse events (23% vs. 19%) as that observed in patients <60 years. Response rates (range, 71%-80%) and the durations of response (median of 9.9, 11.0, and 9.4 months) were similar in the three groups.
Conclusions: Yttrium-90-ibritumomab tiuxetan produces high rates of clinical response (up to 80%) and durable remissions in patients with NHL, and can be given at standard doses in older patients. The favorable safety profile of the regimen makes it an effective treatment for older patients, who may not otherwise tolerate the adverse events associated with chemotherapy.