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A phase 1 trial of 90Y-Zevalin radioimmunotherapy with autologous stem cell transplant for multiple myeloma. Bone Marrow Transplant 2017 Oct;52(10):1372-1377

Date

09/05/2017

Pubmed ID

28869617

DOI

10.1038/bmt.2017.164

Scopus ID

2-s2.0-85030702614   4 Citations

Abstract

This phase 1 study (clinical trial NCT00477815) was conducted to determine the maximum tolerated dose (MTD) of yttrium-90 ibritumomab tiuxetan (90Y-Zevalin) with high dose melphalan (HDM) therapy in multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT). In a 3+3 trial design, 30 patients received rituximab 250 mg/m2 with indium-111 ibritumomab tiuxetan (111In-Zevalin) for dosimetry (day -22); rituximab 250 mg/m2 with escalating doses of 90Y-Zevalin (day -14); melphalan 100 mg/m2 (days -2,-1) followed by ASCT (day 0) and sargramostim (GM-CSF, day 0) until neutrophil engraftment. Each patient's 111In-Zevalin dosimetry data were used to calculate the dose of 90Y-Zevalin (in mCi) to deliver 10, 12, 14, 16, 18 or 20 Gy to the liver. Dose limiting toxicities were seen in 3 patients. The overall response rate was 73% (22/30) with stringent complete response in 2 patients; complete response, 5; very good partial response, 12; and partial response, 3. The median PFS was 16.5 months and the median overall survival was 63.4 months. In MM, the MTD of 90Y-Zevalin with HDM is 18 Gy to the liver. The addition of radiation with novel delivery methods such as radioimmunotherapy combined with standard transplant regimens warrants further study.

Author List

Dispenzieri A, D'Souza A, Gertz MA, Laumann K, Wiseman G, Lacy MQ, LaPlant B, Buadi F, Hayman SR, Kumar SK, Dingli D, Hogan WJ, Ansell SM, Gastineau DA, Inwards DJ, Micallef IN, Porrata LF, Johnston PB, Litzow MR, Witzig TE

Author

Anita D'Souza MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antibodies, Monoclonal
Autografts
Disease-Free Survival
Female
Granulocyte-Macrophage Colony-Stimulating Factor
Hematopoietic Stem Cell Transplantation
Humans
Male
Maximum Tolerated Dose
Melphalan
Middle Aged
Multiple Myeloma
Radioimmunotherapy
Recombinant Proteins
Rituximab
Survival Rate
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a