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- Title
Myeloablative doses of yttrium-90-ibritumomab tiuxetan and the risk of secondary myelodysplasia/acute myelogenous leukemia.
- Authors
Guidetti, Anna; Carlo-Stella, Carmelo; Ruella, Marco; Miceli, Rosalba; Devizzi, Lilli; Locatelli, Silvia L.; Giacomini, Arianna; Testi, Adele; Buttiglieri, Stefano; Risso, Alessandra; Mariani, Luigi; Di Nicola, Massimo; Passera, Roberto; Tarella, Corrado; Gianni, Alessandro M.
- Abstract
BACKGROUND: Because the long-term toxicity of myeloablative radioimmunotherapy remains a matter of concern, the authors evaluated the hematopoietic damage and incidence of secondary myelodysplastic syndrome and acute myelogenous leukemia (sMDS/AML) in patients who received myeloablative doses of the radiolabeled antibody yttrium-90 (90Y)-ibritumomab tiuxetan. METHODS: The occurrence of sMDS/AML was investigated prospectively in 53 elderly patients with non-Hodgkin lymphoma (NHL) who underwent an autograft after high-dose radioimmunotherapy (HD-RIT) myeloablative conditioning with 90Y-ibritumomab tiuxetan. Bone marrow (BM) hematopoietic progenitors and telomere length (TL) also were investigated. RESULTS: At a median follow-up of 49 months, 4 patients developed sMDS/AML at 6 months, 12 months, 27 months, and 36 months after HD-RIT, and the 5-year cumulative incidence of sMDS/AML was 8.29%. A significant but transient decrease in BM granulocyte-macrophage progenitors was observed; whereas multilineage, erythroid, and fibroblast progenitors were unaffected. A significant and persistent shortening of BM TL also was detected. A matched-pair analysis comparing the study patients with 55 NHL patients who underwent autografts after chemotherapy-based myeloablative conditioning demonstrated a 8.05% 5-year cumulative incidence of sMDS/AML. CONCLUSIONS: HD-RIT for patients with NHL was associated with 1) limited toxicity on hematopoietic progenitors, 2) accelerated TL shortening, and 3) non-negligible incidence of sMDS/AML, which nevertheless was comparable to the incidence observed in a matched group of patients who received chemotherapy-based conditioning. Thus, in the current series of elderly patients with NHL, the development of sMDS/AML was not influenced substantially by HD-RIT. Cancer 2011;. © 2011 American Cancer Society.
- Subjects
MYELODYSPLASTIC syndromes treatment; HODGKIN'S disease; ACUTE myeloid leukemia treatment; RADIOTHERAPY; DRUG therapy; YTTRIUM; THERAPEUTICS
- Publication
Cancer (0008543X), 2011, Vol 117, Issue 22, p5074
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.26182