International Journal of Hematology

DOI: 10.1007/s12185-018-2526-z Pages: 1-7

Tumor long-axis diameter and SUVmax predict long-term responders in 90Y-ibritumomab tiuxetan monotherapy

1. Gunma University Hospital, Oncology Center

2. Gunma University Graduate School of Medicine, Department of Hematology

3. Gunma University Hospital, Transfusion Service

4. University Graduate School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine

5. National Hospital Organization Shibukawa Medical Center, Department of Hematology

6. Fujioka General Hospital, Division of Internal Medicine

7. Saiseikai Maebashi Hospital, Division of Internal Medicine

8. Maebashi Red Cross Hospital, Division of Internal Medicine

9. Gunma University Graduate School of Health Sciences, Department of Laboratory Sciences

10. Shinshu University School of Medicine, Department of Biomedical Laboratory Medicine

Correspondence to:
Norifumi Tsukamoto
Tel: +81-27-220-8529
Email: tsukamoto@gunma-u.ac.jp

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Abstract

90Y-ibritumomab tiuxetan (90Y-IT) is widely used, but the factors responsible for its optimal treatment effects are unknown. We enrolled 34 patients with relapsed indolent lymphoma treated with 90Y-IT monotherapy at Gunma University Hospital between 2003 and 2014 in the present study. Clinical data including computed tomography and 18-Fluoro-deoxyglucose positron emission tomography were retrospectively analyzed. The overall response rate and complete response rate were 91% and 82%, respectively. The median progression-free survival (PFS) and overall survival were 32 months and not reached, respectively. In univariate analysis, tumor long-axis diameter ≤ 2.5 cm, maximum standardized uptake value (SUVmax) ≤ 6.5, localized disease, normal levels of serum soluble interleukin-2 receptor, and the number of involved nodal sites ≤ 3 immediately prior to 90Y-IT were associated with median PFS greater than 6 years. However, in multivariate analysis, only tumor long-axis diameter ≤ 2.5 cm and SUVmax ≤ 6.5 affected PFS [hazard ratio (HR) 0.130, P = 0.0021 and HR 0.283, P = 0.0311, respectively]. Patients with only one prior regimen needed less granulocyte colony-stimulating factor and platelet transfusion. Thus, 90Y-IT treatment should be considered for patients with indolent lymphoma in first relapse who have tumor long-axis diameter ≤ 2.5 cm and SUVmax ≤ 6.5.

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