transformed lymphoma transformed non-Hodgkin's lymphoma
Conditions
Interventions
None listed
Sponsors
Vrije Universiteit Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: * First diagnosis of transformation of lymphoma;* Histologically confirmed CD20 positive transformed B cell NHL lymphoma, according to the WHO classification 2008 , stage I-IV. ;* For consolidation with AuSCT after Z-BEAM: age 18-71 years old;* For single dose 90Y-ibritumomab tiuxetan: older than 70 years and 18-71 years but ineligible for autologous stem cell transplantation ;* WHO performance status of 0-2 (Appendix C);* Life expectancy of at least 3 months;* Induction treatment with R-CHOP or R-DHAP-VIM-DHAP;* CR defined as disappearance of all evidence of disease on PET-CT or PR defined as a reduction of tumor size of more than 50% and decreasing FDG-avidity on PET-CT after induction consisting of rituximab containing polychemotherapy. (see appendix A);* Absense of PET positive bulky disease after induction treatment defined as a lesion larger than 5 cm;* Less than 25% bone marrow involvement at the end of induction treatment (measurement in a representative bone marrow biopsy) ;* For AuSCT: Stem cells harvested: a minimum of 2 x 106 CD34+ cells/kg ;* For single dose 90Y-ibritumomab tiuxetan: ANC * 1.5 x 109/l and platelets * 100 x 109/l;* Written informed consent obtained according to local guidelines
Exclusion criteria
Exclusion criteria: * Known hypersensitivity to murine antibodies or proteins;* Presence of any other active neoplasms or history of prior malignancy, except non-melanoma skin tumours or stage 0 (in situ) cervical carcinoma during the past 5 years;* Patients with abnormal liver function (total bilirubin > 2.0 x ULN);* Presence of CNS involvement ;* Patients with pleural effusion or ascites after induction therapy;* Patients who have received G-CSF or GM-CSF therapy within two weeks prior to study enrollment;* Patients who have received biologic therapy, immunotherapy, R-CHOP(-like) chemotherapy, surgery, or an investigational drugs less than 4 weeks prior to first day of study treatment (i.e. 90Yttrium ibritumomab tiuxetan + AuSCT) or who have not recovered from the toxic effects of such therapy;* Female patients who are pregnant or breast feeding, or adults of reproductive potential not employing an effective method of birth control during study treatment and for at least 12 months thereafter;* Known diagnosis of HIV infection;* Patients unwilling or unable to comply with the protocol;Additional exclusion criteria for autologous SCT:;* Unfit for high dose chemotherapy followed by autologous stem cell transplantation due to physical or mental condition.;Additional exclusion criteria for single dose 90Y-ibritumomab tiuxetan;* Patients who have received prior external beam radiotherapy to > 25% of active bone marrow (involved field or regional).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 2 year progression free survival. | — |
Secondary
| Measure | Time frame |
|---|---|
| 2 year overall survival time to next treatment conversionrate of PR to CR as measured by PET-CT if in PR before consolidation therapy. recovery of immunoglobins, B-,T-, and NK-cell subsets measured at different time points after consolidation therapy. | — |
Countries
Netherlands
Outcome results
None listed