PT  - JOURNAL ARTICLE
AU  - Papajik, Tomas
AU  - Prochazka, Vit
AU  - Raida, Ludek
AU  - Kubova, Zuzana
AU  - Myslivecek, Miroslav
AU  - Drymlova, Jaroslava
AU  - Buriankova, Eva
AU  - Kucerova, Ladislava
AU  - Indrak, Karel
TI  - Relapsed follicular lymphoma sequentially treated with rituximab and <sup>90</sup>Y-ibritumomab tiuxetan. Case report
DP  - 2007 Jun 1
TA  - Biomedical papers
PG  - 109--112
VI  - 151
IP  - 1
AID - 10.5507/bp.2007.020
IS  - 12138118
AB  - Background: Monoclonal antibodies have dramatically changed the treatment possibilities for follicular lymphoma. <sup>90</sup>Y-ibritumomab tiuxetan (Zevalin®) is the first radioimmunotherapy agent approved for the treatment of relapsed and resistant follicular lymphoma patients. Long-term benefit was observed especially for patients achieving CR after radioimmunotherapy.
Methods and Results: A 65-year-old female patient with the second relapse of CD20 positive follicular lymphoma and multiple concomitant diseases was treated with four weekly doses of rituximab (375 mg/m<sup>2</sup>). <sup>18</sup>F-fl uoro-deoxyglucose positron emission tomography combined with computed tomography (PET-CT) demonstrated only partial response to therapy with persistent PET scan positivity in enlarged abdominal lymph nodes. Therefore, it was decided to treat her with a 1200-MBq (32-mCi) dose of <sup>90</sup>Y-ibritumomab tiuxetan radioimmunotherapy. No acute complications were noted afterwards. Hematological nadirs were reached 4 weeks later, with a platelet count of 24x10<sup>9</sup>/l that normalized within the next 2 weeks. The patient had neither infection nor bleeding complications. Eight weeks after radioimmunotherapy, the PET-CT scans documented only 3 lymph nodes around the abdominal aorta, maximum size 2x1 cm. The PET scan analysis proved no accumulation of <sup>18</sup>F-fluoro-deoxy-glucose in any lymph nodes or other organs and tissues.
Conclusions: Sequential treatment with rituximab and <sup>90</sup>Y-ibritumomab tiuxetan may be an interesting alternative in cases of relapsed follicular or other indolent lymphomas in pretreated or older patients with other concomitant diseases.