Radioimmunotherapy for B-cell non-hodgkin lymphomas

Cancer Control. 2012 Jul;19(3):196-203. doi: 10.1177/107327481201900304.


Background: Radioimmunotherapy (RIT) is a safe and effective therapeutic option for patients with indolent B-cell non-Hodgkin lymphomas (NHL), in both up-front and relapsed/refractory settings. Two approved agents (90Y-ibritumomab tiuxetan and 131I-tositumomab) are available in the United States. Both target CD20 with similar clinical outcomes but with unique clinical considerations and radiation precautions due to the use of varying radioisotopes.

Methods: This paper reviews the available evidence for these approved RIT agents and examines the recently published and ongoing clinical trials of potential novel indications for aggressive B-cell NHL.

Results: A pretreatment biodistribution evaluation required before administering the 90Y-ibritumomab tiuxetan therapeutic dose has been removed, which once limited its usage. The potential clinical applications of RIT include relapsed/refractory indolent B-cell NHL, diffuse large B-cell lymphoma, indolent lymphoma in the front-line setting, and mantle cell lymphoma. Multiple novel RIT agents are in preclinical and clinical development, and the addition of radiosensitizers or external-beam radiotherapy may act in synergy with RIT for both indolent and aggressive lymphomas. The risk of treatment-related myelodysplastic syndrome does not appear to be higher in patients treated with RIT over those receiving chemotherapy alone.

Conclusions: RIT is a safe, effective, and significantly underutilized therapy for patients with B-cell NHL, and many studies have demonstrated the efficacy of 90Y-ibritumomab tiuxetan and 131I-tositumomab for relapsed/refractory indolent B-cell lymphomas. Continued research to establish its efficacy for other lymphoma subtypes is warranted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Lymphoma, B-Cell / radiotherapy*
  • Radioimmunotherapy / adverse effects
  • Radioimmunotherapy / methods*
  • Radiopharmaceuticals / therapeutic use
  • Yttrium Radioisotopes / therapeutic use


  • Antibodies, Monoclonal
  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • ibritumomab tiuxetan
  • tositumomab I-131