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Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results

Issa F. Khouri, Rima M. Saliba, William D. Erwin, Barry I. Samuels, Martin Korbling, L. Jeffrey Medeiros, Rosamar Valverde, Amin M. Alousi, Paolo Anderlini, Qaiser Bashir, Stefan Ciurea, Alison M. Gulbis, Marcos de Lima, Chitra Hosing, Partow Kebriaei, Uday R. Popat, Nathan Fowler, Sattva S. Neelapu, Felipe Samaniego, Richard E. Champlin and Homer A. Macapinlac

Abstract

In 2008, we reported favorable 5-year outcomes of nonmyeloablative allogeneic stem cell transplantation after fludarabine, cyclophosphamide, rituximab (FCR) conditioning for relapsed and chemosensitive follicular lymphoma. However, innovative strategies were still needed to treat patients with chemo-refractory disease. We therefore subsequently performed a trial in which 90Y-ibritumomab tiuxetan (0.4 mCi/kg) was added to the FC conditioning regimen (90YFC). Here, we report updated results of the FCR trial and outcomes after 90YFC. FCR group (N=47). Since the last update, one patient developed recurrent disease. With a median follow-up of 107 months (range 72-142), the 11-year overall (OS) and progression-free survival (PFS) rates were 78%, and 72%. 90YFC group (N=26). More patients in the 90YFC group had chemo-refractory disease than did those in the FCR group (38% and 0%, P < .001). With a median follow-up of 33 months (range,17-94 months), the 3-year PFS rates for patients with chemo-refractory and chemosensitive disease were 80% and 87% (P = .7). The low frequency of relapse observed after a long follow-up interval of 9 years in the FCR group suggests that these patients are cured of their disease. The addition of 90Y to the conditioning regimen appears to be effective in patients with chemo-refractory disease. This trial is registered at www.ClinicalTrials.gov number, NCT00048737.

  • Submitted March 19, 2012.
  • Accepted May 6, 2012.