alexa Utilization of Radioimmunotherapy (RIT) and Hematopoietic Stem Cell Transplantation (HSCT) in B-cell Non-Hodgkin’s Lymphoma (NHL): 10 Year Experience of a Single Community Cancer Center
ISSN: 2155-9619

Journal of Nuclear Medicine & Radiation Therapy
Open Access

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Research Article

Utilization of Radioimmunotherapy (RIT) and Hematopoietic Stem Cell Transplantation (HSCT) in B-cell Non-Hodgkin’s Lymphoma (NHL): 10 Year Experience of a Single Community Cancer Center

Nibal Saad1*, Kleanthe Kolizeras2, Susan M Szpunar3 and Ayad Al-Katib2

1Department of Hematology/Oncology, State University of New York Upstate Medical University, Syracuse, NY, USA

2Van Elslander Cancer Center, Grosse Pointe Woods, Michigan, USA

3Graduate Medical Education, St John Hospital & Medical Center, Detroit, USA

*Corresponding Author:
Nibal Saad
Department of Hematology/Oncology
State University of New York Upstate Medical University, Syracuse
NY, USA
Tel: 313 706 6607
Fax: 315 464-8279
E-mail: [email protected]

Received date: April 11, 2017; Accepted date: April 20, 2017; Published date: April 27, 2017

Citation: Saad B, Kolizeras K, Szpunar SM, Al-Khatib A (2017) Utilization of Radioimmunotherapy (RIT) and Hematopoietic Stem Cell Transplantation (HSCT) in B-cell Non-Hodgkin’s Lymphoma (NHL): 10 Year Experience of a Single Community Cancer Center. J Nucl Med Radiat Ther 8:331. doi:10.4172/2155-9619.1000331

Copyright: © 2017 Saad N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

 

Abstract

After Yttrium (Y90) Ibritumomab tiuxetan (Zevalin) and Iodine (131I) tositumomab (Bexxar) were approved by the FDA, the improved response of B-cell NHL to this novel RIT makes it a promising alternative to more aggressive treatment like HSCT. In this study, we describe the experience of a single community-based cancer with RIT and HSCT in patients with B-cell NHL in terms of response, survival and toxicity. Retrospectively, we reviewed 75 patients with B cell NHL who were treated with either RIT (N=50) or HSCT (N=25) between 2003 and 2013. Choice of treatment modality, i.e. RIT vs. HSCT was based on discretion of treating Oncologist taking into consideration patient’s age, performance status, comorbidity and preferences. RIT-treated patients were older. HSCT was more likely to be used in aggressive lymphoma and as a consolidation of primary therapy. RIT was used mainly in indolent lymphoma and as salvage treatment. Overall response rates were better in HSCT-treated patients (100% vs. 76%). Median overall survival was higher in HSCT-treated patients (221 vs. 79.4 months). Similar results were obtained when we compared OS in patients younger than 60 years (221 vs. 79.4 months) and in patients with aggressive lymphoma (221 vs. 59.7 months). PFS was not met in HSCT, while it was 16.2 months in RIT. Myelodysplastic syndrome (MDS) occurred in both groups (12% HSCT vs. 2% RIT). Thrombocytopenia was more prevalent with RIT. All other toxicities were significantly more common with HSCT. This study shows that, in clinical practice, younger patients with aggressive B-cell NHL and without significant comorbidity are more likely to be offered HSCT. On the other hand, RIT was offered to older patients with indolent histology. Our results show that RIT is a reasonable alternative salvage treatment modality for B-cell NHL patients who are not candidates for HSCT.

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