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Nordic MCL3 study: Y-90-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma

Kolstad, Arne; Laurell, Anna; Jerkeman, Mats LU ; Gronbaek, Kirsten; Elonen, Erkki; Raty, Riikka; Pedersen, Lone Bredo; Loft, Annika; Bogsrud, Trond Velde and Kimby, Eva, et al. (2014) In Blood 123(19). p.2953-2959
Abstract
The main objective of the MCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90 Y-ibritumomab-tiuxetan (Zevalin) to the high-dose regimen. One hundred sixty untreated, stage II-IV mantle cell lymphoma patients <66 years received rituximab (R)-maxi-CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) alternating with R-high-dose cytarabine (6 cycles total), followed by high-dose BEAM/C (bis-chloroethylnitrosourea, etoposide, cytarabine, and melphalan or cyclophosphamide) and autologous stem cell transplantation from 2005 to 2009. Zevalin (0.4 mCi/kg) was given to responders not in CR before transplant. Overall response rate pretransplant was 97%. The outcome did... (More)
The main objective of the MCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90 Y-ibritumomab-tiuxetan (Zevalin) to the high-dose regimen. One hundred sixty untreated, stage II-IV mantle cell lymphoma patients <66 years received rituximab (R)-maxi-CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) alternating with R-high-dose cytarabine (6 cycles total), followed by high-dose BEAM/C (bis-chloroethylnitrosourea, etoposide, cytarabine, and melphalan or cyclophosphamide) and autologous stem cell transplantation from 2005 to 2009. Zevalin (0.4 mCi/kg) was given to responders not in CR before transplant. Overall response rate pretransplant was 97%. The outcome did not differ from that of the historic control: the MCL2 trial with similar treatment except for Zevalin. Overall survival (OS), event-free survival (EFS), and progression-free survival (PFS) at 4 years were 78%, 62%, and 71%, respectively. For responding non-CR patients who received Zevalin, duration of response was shorter than for the CR group. Inferior PFS, EFS, and OS were predicted by positron emission tomography (PET) positivity pretransplant and detectable minimal residual disease (MRD) after transplant. In conclusion, positive PET and MRD were strong predictors of outcome. Intensification with Zevalin may be too late to improve the outcome of patients not in CR before transplant. This trial was registered at www.clinicaltrials.gov as #NCT00514475. (Less)
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Contribution to journal
publication status
published
subject
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Blood
volume
123
issue
19
pages
2953 - 2959
publisher
American Society of Hematology
external identifiers
  • wos:000335897900013
  • scopus:84900442345
ISSN
1528-0020
DOI
10.1182/blood-2013-12-541953
language
English
LU publication?
yes
id
029d925b-22f4-4ecc-b4e7-93e5d1d8efff (old id 4469928)
date added to LUP
2014-07-01 07:41:17
date last changed
2017-11-19 03:03:38
@article{029d925b-22f4-4ecc-b4e7-93e5d1d8efff,
  abstract     = {The main objective of the MCL3 study was to improve outcome for patients not in complete remission (CR) before transplant by adding 90 Y-ibritumomab-tiuxetan (Zevalin) to the high-dose regimen. One hundred sixty untreated, stage II-IV mantle cell lymphoma patients &lt;66 years received rituximab (R)-maxi-CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) alternating with R-high-dose cytarabine (6 cycles total), followed by high-dose BEAM/C (bis-chloroethylnitrosourea, etoposide, cytarabine, and melphalan or cyclophosphamide) and autologous stem cell transplantation from 2005 to 2009. Zevalin (0.4 mCi/kg) was given to responders not in CR before transplant. Overall response rate pretransplant was 97%. The outcome did not differ from that of the historic control: the MCL2 trial with similar treatment except for Zevalin. Overall survival (OS), event-free survival (EFS), and progression-free survival (PFS) at 4 years were 78%, 62%, and 71%, respectively. For responding non-CR patients who received Zevalin, duration of response was shorter than for the CR group. Inferior PFS, EFS, and OS were predicted by positron emission tomography (PET) positivity pretransplant and detectable minimal residual disease (MRD) after transplant. In conclusion, positive PET and MRD were strong predictors of outcome. Intensification with Zevalin may be too late to improve the outcome of patients not in CR before transplant. This trial was registered at www.clinicaltrials.gov as #NCT00514475.},
  author       = {Kolstad, Arne and Laurell, Anna and Jerkeman, Mats and Gronbaek, Kirsten and Elonen, Erkki and Raty, Riikka and Pedersen, Lone Bredo and Loft, Annika and Bogsrud, Trond Velde and Kimby, Eva and Hansen, Per Boye and Fagerli, Unn-Merete and Nilsson-Ehle, Herman and Lauritzsen, Grete Fossum and Lehmann, Anne Kristine and Sundstrom, Christer and Karjalainen-Lindsberg, Marja-Liisa and Ralfkiaer, Elisabeth and Ehinger, Mats and Delabie, Jan and Bentzen, Hans and Schildt, Jukka and Kostova-Aherdan, Kamelia and Frederiksen, Henrik and Brown, Peter de Nully and Geisler, Christian H.},
  issn         = {1528-0020},
  language     = {eng},
  number       = {19},
  pages        = {2953--2959},
  publisher    = {American Society of Hematology},
  series       = {Blood},
  title        = {Nordic MCL3 study: Y-90-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma},
  url          = {http://dx.doi.org/10.1182/blood-2013-12-541953},
  volume       = {123},
  year         = {2014},
}