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Yttrium-90 ibritumomab tiuxetan plus ATG/TLI for allogeneic hematopoietic cell transplantation in non-Hodgkin lymphoma

Bone Marrow Transplantation volume 58, pages 1143–1145 (2023)Cite this article

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Allogeneic hematopoietic cell transplantation (alloHCT) may provide durable remissions in patients with relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma (B-NHL) who relapse after an autologous HCT [1] or chimeric antigen receptor (CAR) T-cell therapy [2, 3]. However, many patients are unfit for myeloablative conditioning (MAC) [1]. Anti-thymocyte globulin plus total lymphoid irradiation (ATG/TLI) is a non-myeloablative (NMA) regimen that was designed to suppress graft-vs-host disease (GVHD) while preserving graft-vs-lymphoma (GVL) activity, and has demonstrated clinical success [1]. However, patients with stable or progressive disease at the time of transplant have worse outcomes [1]. Yttrium-90 ibritumomab tiuxetan (90Y-IT) is a form of radioimmunotherapy that has been safely combined with various transplant conditioning regimens to amplify the conditioning intensity to improve outcomes [4, 5]. Thus, we hypothesized that combining 90Y-IT with ATG/TLI (90Y-IT + ATG/TLI), could convert those with less than a complete response (<CR) at the time of alloHCT to a CR to improve transplant outcomes.

We conducted a prospective single-arm, open label phase II trial at University of California Davis Medical Center involving adults with R/R CD20 + B-NHL in <CR with adequate organ function and performance status between March 2014-October 2020 (NCT01811368). Our Institutional Review Board approved the study. All patients provided informed consent. The treatment schema is provided in Supplementary Fig. 1.

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Fig. 1

Data availability

Raw data used to generate these results are available upon request. Please contact the corresponding author.

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Acknowledgements

Funding and supply of 90Y-IT was provided by Acrotech Biopharma.

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Authors and Affiliations

  1. University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA

    Tamer Othman, Carol Richman, Rasmus Hoeg, Mehrdad Abedi & Joseph Tuscano

  2. Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA

    Robert Lowsky

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Contributions

TO collected and analyzed data, and wrote the paper. RL collected data and edited the paper. CR performed research. RT performed research and edited the paper. MA performed research and edited the paper. JT designed and performed the research, analyzed data, wrote and edited the paper.

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Correspondence to Joseph Tuscano.

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MA—Speakers bureau for Gilead (Kite), BMS, and AbbVie; Advisory board for BMS. TO, RL, CR, RT, JT have no conflicts of interest to disclose.

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Othman, T., Lowsky, R., Richman, C. et al. Yttrium-90 ibritumomab tiuxetan plus ATG/TLI for allogeneic hematopoietic cell transplantation in non-Hodgkin lymphoma. Bone Marrow Transplant 58, 1143–1145 (2023). https://doi.org/10.1038/s41409-023-02025-0

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