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Use of Radioimmunotherapy in Stem Cell Transplantation and

Posttransplantation: Focus on Yttrium 90 Ibritumomab Tiuxetan

Authors: Molina, Arturo; Krishnan, Amrita; Fung, Henry; Flinn, Ian W.;

Inwards, ; Winter, Jane N.; Nademanee, Auayporn

Source: Current Stem Cell Research & Therapy, Volume 2, Number 3, September

2007 , pp. 239-248(10)

Publisher: Bentham Science Publishers

Abstract:

Although autologous stem cell transplantation (ASCT) produces prolonged

disease-free survival in many patients with non-Hodgkin's lymphoma (NHL),

relapse remains the most common cause of treatment failure. Because of the

potential benefit of adding targeted irradiation to conditioning regimens,

clinical trials are testing the safety and efficacy of combining

radioimmunotherapy with yttrium 90 ibritumomab tiuxetan or iodine 131

tositumomab and chemotherapy, either as replacement for total body

irradiation or in addition to standard high-dose chemotherapy (HDC)

regimens.

Current strategies include using standard or escalated doses of

radioimmunoconjugates with HDC before ASCT in patients with relapsed or

refractory B-cell NHL. We reviewed the safety and efficacy of 90 Y

ibritumomab tiuxetan as part of the conditioning regimen before ASCT.

Preliminary data from phase 1 and 2 trials show that 90Y ibritumomab

tiuxetan may be safely added to HDC preparative regimens for high-risk

B-cell NHL.

Additionally, comparisons of outcomes with radioimmunotherapy and ASCT with

historical controls suggest that it may be more effective than conventional

regimens. Results of 90Y ibritumomab tiuxetan alone posttransplantation in

select patients who have relapsed after HDC and ASCT are also encouraging.

Studies of 90Y ibritumomab tiuxetan in the setting of allogeneic stem cell

transplantation appear promising as well.

Keywords: Stem cell transplantation; non-Hodgkin's lymphoma;

radioimmunotherapy; ibritumomab tiuxetan

Document Type: Research article