Clinical outcomes of post-remission therapy using (90)yttrium ibritumomab tiuxetan (Zevalin®) for high-risk patients with diffuse large B-cell lymphoma

Ann Hematol. 2011 Sep;90(9):1075-82. doi: 10.1007/s00277-011-1191-6. Epub 2011 Feb 19.


This phase II trial evaluated the efficacy and safety of tandem consolidation using (90)yttrium ibritumomab tiuxetan ((90)Y-IT) and high-dose therapy (HDT) with autologous peripheral blood stem cell transplantation (PBSCT) in high-risk patients with diffuse large B-cell lymphoma (DLBCL) who were in primary remission. Eleven patients with high-risk DLBCL were enrolled. All patients had achieved complete or partial response after six to eight cycles of rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as a frontline chemotherapy. Subsequently, the patients received one to two courses of ifosfamide-containing regimen for peripheral blood stem cell mobilization and harvesting. First consolidation with (90)Y-IT was performed, followed by second consolidation using HDT with PBSCT. All patients received (90)Y-IT therapy, but three patients did not undergo PBSCT. During the median follow-up period of 18.1 months, 9 of 11 patients exhibited disease progression, and 8 patients died. The estimated 2-year progression-free survival was 18.2%, and overall survival was 36.4%. Adverse events following (90)Y-IT consolidation were primarily transient hematologic toxicities. The present pilot study suggests that tandem consolidation therapy using (90)Y-IT followed by HDT with autologous PBSCT is not feasible for treatment of high-risk patients with DLBCL in remission after R-CHOP. In addition, this treatment failed to provide beneficial effects for the clinical outcome of subsequent PBSCT.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / prevention & control*
  • Lymphoma, Large B-Cell, Diffuse / radiotherapy*
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation / methods
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Radioimmunotherapy / methods
  • Radiotherapy, Adjuvant / methods
  • Remission Induction
  • Risk Factors
  • Rituximab
  • Secondary Prevention
  • Transplantation, Autologous
  • Treatment Outcome
  • Vincristine / administration & dosage
  • Vincristine / therapeutic use


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab
  • ibritumomab tiuxetan
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol