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Prepublished online as a Blood First Edition Paper on May 15, 2003; DOI 10.1182/blood-2003-02-0622. This Article Full Text (PDF) All Versions of this Article: 2003-02-0622v1 102/7/2351    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gopal, A. K Articles by Press, O. W Search for Related Content PubMed PubMed Citation Articles by Gopal, A. K Articles by Press, O. W Related Collections Related Letter in Blood Online Social Bookmarking                   What's this? Submitted February 26, 2003 Accepted May 12, 2003 High-dose radioimmunotherapy versus conventional high-dose therapy and autologous hematopoietic stem cell transplantation for relapsed follicular non-Hodgkin's lymphoma: a multivariable cohort analysis Ajay K Gopal*, Theodore A Gooley, David G Maloney, Stephen H Petersdorf, Janet F Eary, Joseph G Rajendran, Sharon A Bush, Lawrence D Durack, Jane Golden, Paul J Martin, Dana C Matthews, Frederick R Appelbaum, Irwin D Bernstein, and Oliver W Press Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, USA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA Department of Radiology, Division of Nuclear Medicine, University of Washington, Seattle, WA, USA Department of Biostatistics, University of Washington, Seattle, WA, USA Department of Pediatrics, University of Washington, Seattle, WA, USA * Corresponding author; email: agopal{at}u.washington.edu. We performed a multivariable comparison of 125 consecutive follicular lymphoma (FL) patients treated at our centers with either high-dose radioimmunotherapy (HD-RIT) using 131I-anti-CD20 (n=27) or conventional high-dose therapy (C-HDT) (n=98) and autologous hematopoietic stem cell transplantation. The groups were similar, though more HD-RIT patients had an elevated pre-transplant lactate dehydrogenase (41% vs. 20%, p=0.03) and elevated international prognostic score (41% vs. 19%, p=0.02). HD-RIT patients received individualized therapeutic doses of 131I-Tositumomab (median 19.7 GBq) to deliver 17 to 31 Gy (median 27 Gy) to critical normal organs. C-HDT patients were treated with total body irradiation plus chemotherapy (70%) or chemotherapy alone (30%). HD-RIT patients experienced improved overall survival (OS) [unadjusted Hazard Ratio (HR) for death = 0.4 (95% CI, 0.2-0.9) p=0.02; adjusted HR 0.3, p=0.004] and progression-free survival (PFS) [unadjusted HR=0.6 (95% C.I., 0.3-1.0), p=0.06, adjusted HR 0.5, p=0.03] versus C-HDT patients. The estimated 5-year OS and PFS were 67% and 48%, respectively for HD-RIT and 53% and 29%, respectively for C-HDT. 100-day treatment-related mortality was 3.7% in the HD-RIT group and 11% in the C-HDT group. The probability of secondary MDS/AML was estimated to be .076 at 8 years in HD-RIT group and .086 at 7 years in the C-HDT group. HD-RIT may improve outcomes versus C-HDT in patients with relapsed FL. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? 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