Aggressive B-cell NHL: FL grade 3b and DLBCL
Conditions
Interventions
Patients will be treated with R-PECC (rituximab, lomustine, etoposide, chlorambucil, prednisone) and 90Y-ibritumomab tiuxetan.
All patients, who have not attained at least a stable disease after 2 c
Sponsors
Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON)
P/a HOVON Data Center
Erasmus MC - Daniel den Hoed
Postbus 5201
3008 AE Rotterdam
Tel: 010 4391568
Fax: 010 4391028
e-mail: hdc@erasmusmc.nl
Eligibility
Inclusion criteria
Inclusion criteria: 1. Histologically confirmed aggressive B-cell NHL according to the World Health Organization (WHO) classification: Follicular lymphoma grade 3b or Diffuse large B-cell lymphoma 2. Refractory disease or histologically confirmed first or second relapse(Refractory is defined as no response or partial remission according to CT. Patients in partial response (PR) can only be included in case of positive PET scan or positive biopsy) 3. CD20 positive (assessed at 1st diagnosis or from fresh histology at confirmation of relapse or immunophenotyping of circulating CD20-positive NHL cells from peripheral blood) 4. Current measurable disease, i.e. measurable in two perpendicular dimensions on physical examination or computerized tomography (CT) scan using standardized response criteria for NHL (Cheson et al, 1999) 5. Age > 18 years 6. WHO performance status 0, 1 or 2 7. Life expectancy of at least 3 months 8. Absolute neutrophil count > 1.5 x 109/l and platelet count > 100 x 109/l (unless caused by NHL infiltration in the bone marrow) 9. Written informed consent
Exclusion criteria
Exclusion criteria: 1. Prior allogeneic stem cell transplantation- 2. Prior radioimmunotherapy 3. Patients who have received chemotherapy or radiotherapy within 6 weeks prior to study entry or who have not recovered from toxicities related to prior therapies 4. Eligibility for ASCT- ASCT within 12 months of study entry 5. Investigational drugs within 4 weeks prior to entry on this study or persistent toxic side effects of such therapy 6. Treatment with external-beam radiation therapy to more than 25% of active bone marrow 7. A history of intolerance to rituximab 8. Severe cardiac, pulmonary, neurological, psychiatric or metabolic disease which could compromise participation in the study, or serious underlying medical conditions which could impair the ability of the patient to participate in the trial 9. Hepatic dysfunction, bilirubin or transaminases >= 2.5 x upper normal limit (unless caused by the NHL) 10. Renal dysfunction, serum creatinine >=180 mmol/l or clearance <= 40 ml/min (unless caused by the NHL) 11. Active uncontrolled infections 12. Patients known to be HIV-positive 13. Current or chronic hepatitis B or hepatitis C infection 14. Symptomatic NHL localization in the central nervous system (CNS). Lumbal puncture is not required unless CNS involvement with NHL is clinically suspected 15. Transformed indolent lymphoma 16. Post-transplant lymphoproliferative disorder 17. Pregnant or breast-feeding female patients. Negative serum pregnancy test at study is mandatory for female patients of childbearing potential
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| - The incidence of grade >=3 adverse events after treatment with 90Y-ibritumomab tiuxetan. - Failure free survival measured from the start of 90Y-ibritumomab tiuxetan | — |
Secondary
| Measure | Time frame |
|---|---|
| - Incidence and duration of hypoplasia after treatment with 90Y-ibritumomab tiuxetan - Incidence of adverse events after treatment with 90Y-ibritumomab tiuxetan - Incidence of adverse events after treatment with R-PECC - Percentage of patients treated with R-PECC who proceed to 90Y-ibritumomab tiuxetan treatment - Conversion to PET negative CR after 90Y-ibritumomab tiuxetan treatment of patients who are PET positive before start of 90Y-ibritumomab tiuxetan - Overall survival measured from the start of 90Y-ibritumomab tiuxetan - Response rates to R-PECC and response duration - Failure free survival and overall survival measured from the start of R-PECC | — |
Contacts
Public ContactP.J. Lugtenburg
Erasmus MC Afd. Hematologie Postbus 2040
Outcome results
None listed