Nordic MCL-3 study: 90Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma

Nordic MCL-3 study : 90Y-ibritumomab-tiuxetan added to BEAM/C in non-CR patients before transplant in mantle cell lymphoma

The main objective of the MCL3 study was to improve outcome for patients not in CR before transplant by adding (90)Y-ibritumomab-tiuxetan (Zevalin) to the high-dose regimen. 160 consecutive, untreated stage II-IV MCL patients < 66 years received rituximab (R)- maxi-CHOP alternating with R-high-dose Ara-C (6 cycles total), followed by high-dose BEAM or BEAC and autologous stem cell transplantation 2005-2009. Zevalin (0.4 mCi/kg) was given to responders in only CRu/PR prior to high-dose therapy. The overall response rate (ORR) pre-transplant was 97%. After a median follow-up of 4.4 years the outcome did not differ from that of the historic control, the MCL2 trial with the same treatment except for Zevalin. Overall (OS), event free (EFS), and progression-free survival (PFS) at 4 years were 78, 62 and 71%, respectively. For patients in CRu/PR before transplant who received Zevalin duration of response was shorter than in the CR group. Inferior PFS, EFS- and OS were predicted by PET-positivity pre-transplant and detectable minimal residual disease (MRD) before and after transplant. In conclusion, a positive PET prior to transplant and MRD are strong predictors of outcome. Late intensification with Zevalin may be too late to improve the outcome of patients not in CR before transplant.

Laurell, AnnaUppsala universitet,Enheten för onkologi(Swepub:uu)annajohn (author)
Jerkeman, MatsLund University,Lunds universitet,Bröstcancer-genetik,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Breastcancer-genetics,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)onk-mje (author)
Grønbæk, Kirsten (author)
Elonen, ErkkiKarolinska Institutet (author)
Räty, Riikka (author)
Pedersen, Lone Bredo (author)
Loft, Annika (author)
Bogsrud, Trond Velde (author)
Kimby, Eva (author)
Hansen, Per Boye (author)
Fagerli, Unn Merete (author)
Nilsson-Ehle, Herman (author)
Lauritzsen, Grete Fossum (author)
Lehmann, Anne Kristine (author)
Sundström, ChristerUppsala universitet,Molekylär och morfologisk patologi(Swepub:uu)chrisund (author)
Karjalainen-Lindsberg, Marja-Liisa (author)
Ralfkiaer, Elisabeth (author)
Ehinger, MatsLund University,Lunds universitet,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)efor-meh (author)
Delabie, Jan (author)
Bentzen, Hans (author)
Schildt, Jukka (author)
Kostova-Aherdan, KameliaUppsala universitet,Institutionen för medicinska vetenskaper (author)
Frederiksen, Henrik (author)
Brown, Peter de Nully (author)
Geisler, Christian H (author)
Gronbaek, Kirsten (author)
Uppsala universitetEnheten för onkologi (creator_code:org_t)

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Clinical Laborat ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Hematology

By the university: Uppsala University; Lund University; Karolinska Institutet

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