Yttrium-90 ibritumomab tiuxetan consolidation versus rituximab maintenance therapy after induction chemotherapy in patients with indolent non-Hodgkin lymphoma: a single-institution experience

摘要

Objectives: Indolent B-cell non-Hodgkin lymphomas (iNHLs) are considered incurable.Rituximab maintenance and yttrium-90 ibritumomab tiuxetan (90Y-IT) consolidation arepromising post-remission therapies. However, only one randomized phase II trial hascompared their efficacies and adverse effects. Here, we compared the efficacy and safety of 90Y-IT consolidation and rituximab maintenance in iNHL patients.Methods: We retrospectively examined 75 iNHL patients with complete or partial response afterinitial chemotherapy between January 2008 and December 2018. Twenty-seven patientsreceived 90Y-IT consolidation and 48 received rituximab maintenance (every 2 months for 2years). Progression-free survival (PFS), overall survival (OS), and time to next treatment (TTNT)were estimated from the start of the treatment, and adverse effects were evaluated.Results: After a median 3.6-year follow-up, the 5-year PFSs of the 90Y-IT consolidation andrituximab maintenance groups were 75.5% and 82.4%, respectively (log-rank test, p = 0.839),and the 5-year OSs were 100% and 97.8%, respectively (log-rank test, p = 0.465). Thecorresponding median TTNTs were not reached (log-rank test, p = 0.804). The commonestadverse effect with 90Y-IT consolidation was hematotoxicity; lower rates and grades ofcytopenia were observed in patients who received rituximab maintenance. Secondarymalignancies were observed in 1 patient (4%) who received 90Y-IT consolidation and 2patients (4.2%) who received rituximab maintenance (Fisher’s exact test, p 0.99).Conclusion: 90Y-IT consolidation and rituximab maintenance were similar with respect to PFS,OS, and TTNT. However, the features and grades of adverse effects significantly differed. Patientspecificcharacteristics should be considered when deciding post-remission treatments.