RESPONSE ASSESSMENT USING IWG2007 AND DEAUVILLE CRITERIA IN B-CELL NON-HODGKIN LYMPHOMA PATIENTS TREATED WITH 90Y-IT
(Abstract release date: 05/19/16)
EHA Library. Andrade-Campos M. 06/09/16; 134769; PB1869
Dr. Marcio Andrade-Campos
Contributions
Contributions
Abstract
Abstract: PB1869
Type: Publication Only
Background
90Y-Ibritumomab-tiuxetan (90Y-IT) has become an efficient alternative therapy in non-Hodgkin Lymphoma (NHL). The staging and response assessment have changed and PET/CT scan with Deauville/Lugano criteria have become the recommended tool.
Aims
To analyse our updated information of patients treated with 90YIbritumomab/tiuxetan in our institution comparing the IWG2007 Chenson and Lugano/Deauville criteria to analyse treatment outcome.
Methods
120 NHL patients were included in a clinical protocol conducted by a multidisciplinary team and treated in the same centre. For this sub study 54 patients have been included, all of them followed by more than 12 months and the response assessed with PET/CT scan after 12 weeks out therapy using the same machine, the images were available for re-assessment retrospectively according Deauville/Lugano criteria. Endpoints: objective response rate (ORR), time to relapse (PFS) overall survival (OS).
Results
Until August 2015, 56 patients had receive therapy with 90Y-IT and completed at least 1 year of follow-up were considered to analysis; M/F 29/27 mean age 59.7 years (31-86); ECOG 0-1 94.4%. According WHO classification: follicular-NHL 44 (78.6%), mantle cell-NHL 2 (3.6%), DLCB-NHL 7 (12.5%) and MALT-NHL 3 (5.4%). Score risk distribution: low 19 (33.9%), intermediate 24 (42.9%) and advanced 13 (23.2%). 54.5% of patients were stage IV. The majority of patients received ≤2 (90.7%) previous therapy schedules and >2 (9.3%). The mean follow-up time: 53.1 months (95% CI: 12; 145). 31 (57.4%) patients received 90Y-IT as consolidation of first line therapy and 23 relapsed/refractory (42.6%). According IWG2007 criteria: ORR was 98.2 % CR: 50 (92.6%); PR 3 (5.4%) and 1 failure (1.9%) in relapsed/refractory disease. According Lugano following the recommendation of Deauville criteria about the presence of residual mass and the scale of 5 points, the response were: CR (1-2 scores or 3 scores with a reduction respect the baseline and no presence of residual disease) 46 (85.2%), presence of residual disease (scores 4-5 or mass with score 3 without a reduction respect baseline): 8 (14.8%). During follow-up 13 patients (24.1%) had relapsed, 10 were categorized as CR by IWG2007, 9 CR by Lugano and 7 CR by Deauville with a higher negative predictive value. The mean PFS: 109.6 months (95% CI: 94.8; 124.4) median NR. However for patients classified as CR by Deauville, the mean PFS was 117.1 month (102.2 – 132.0), median NR, and 40.7 (16.4 – 65.2), median 16 (6.2 – 25.7) months for the rest, fig 1. During follow up eight patients have dead, 5 of them after 55 or more months after 90Y-IT therapy. Dead were related to disease in 7 patients.
Conclusion
In our series of NHL patients treated with 90Y Ibritumomab tiuxetan, the re-assessment of response by PET/CT scan according Deauville criteria at the end of therapy shows more restrictive for CR when scale 3 combining with residual mass is considering as residual disease, improving the accuracy of CR in 7.4% and prolonged PFS in 7.5 months, respect IWG2007.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Follow-up, PET, Radioimmunotherapy
Type: Publication Only
Background
90Y-Ibritumomab-tiuxetan (90Y-IT) has become an efficient alternative therapy in non-Hodgkin Lymphoma (NHL). The staging and response assessment have changed and PET/CT scan with Deauville/Lugano criteria have become the recommended tool.
Aims
To analyse our updated information of patients treated with 90YIbritumomab/tiuxetan in our institution comparing the IWG2007 Chenson and Lugano/Deauville criteria to analyse treatment outcome.
Methods
120 NHL patients were included in a clinical protocol conducted by a multidisciplinary team and treated in the same centre. For this sub study 54 patients have been included, all of them followed by more than 12 months and the response assessed with PET/CT scan after 12 weeks out therapy using the same machine, the images were available for re-assessment retrospectively according Deauville/Lugano criteria. Endpoints: objective response rate (ORR), time to relapse (PFS) overall survival (OS).
Results
Until August 2015, 56 patients had receive therapy with 90Y-IT and completed at least 1 year of follow-up were considered to analysis; M/F 29/27 mean age 59.7 years (31-86); ECOG 0-1 94.4%. According WHO classification: follicular-NHL 44 (78.6%), mantle cell-NHL 2 (3.6%), DLCB-NHL 7 (12.5%) and MALT-NHL 3 (5.4%). Score risk distribution: low 19 (33.9%), intermediate 24 (42.9%) and advanced 13 (23.2%). 54.5% of patients were stage IV. The majority of patients received ≤2 (90.7%) previous therapy schedules and >2 (9.3%). The mean follow-up time: 53.1 months (95% CI: 12; 145). 31 (57.4%) patients received 90Y-IT as consolidation of first line therapy and 23 relapsed/refractory (42.6%). According IWG2007 criteria: ORR was 98.2 % CR: 50 (92.6%); PR 3 (5.4%) and 1 failure (1.9%) in relapsed/refractory disease. According Lugano following the recommendation of Deauville criteria about the presence of residual mass and the scale of 5 points, the response were: CR (1-2 scores or 3 scores with a reduction respect the baseline and no presence of residual disease) 46 (85.2%), presence of residual disease (scores 4-5 or mass with score 3 without a reduction respect baseline): 8 (14.8%). During follow-up 13 patients (24.1%) had relapsed, 10 were categorized as CR by IWG2007, 9 CR by Lugano and 7 CR by Deauville with a higher negative predictive value. The mean PFS: 109.6 months (95% CI: 94.8; 124.4) median NR. However for patients classified as CR by Deauville, the mean PFS was 117.1 month (102.2 – 132.0), median NR, and 40.7 (16.4 – 65.2), median 16 (6.2 – 25.7) months for the rest, fig 1. During follow up eight patients have dead, 5 of them after 55 or more months after 90Y-IT therapy. Dead were related to disease in 7 patients.
Conclusion
In our series of NHL patients treated with 90Y Ibritumomab tiuxetan, the re-assessment of response by PET/CT scan according Deauville criteria at the end of therapy shows more restrictive for CR when scale 3 combining with residual mass is considering as residual disease, improving the accuracy of CR in 7.4% and prolonged PFS in 7.5 months, respect IWG2007.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Follow-up, PET, Radioimmunotherapy
Abstract: PB1869
Type: Publication Only
Background
90Y-Ibritumomab-tiuxetan (90Y-IT) has become an efficient alternative therapy in non-Hodgkin Lymphoma (NHL). The staging and response assessment have changed and PET/CT scan with Deauville/Lugano criteria have become the recommended tool.
Aims
To analyse our updated information of patients treated with 90YIbritumomab/tiuxetan in our institution comparing the IWG2007 Chenson and Lugano/Deauville criteria to analyse treatment outcome.
Methods
120 NHL patients were included in a clinical protocol conducted by a multidisciplinary team and treated in the same centre. For this sub study 54 patients have been included, all of them followed by more than 12 months and the response assessed with PET/CT scan after 12 weeks out therapy using the same machine, the images were available for re-assessment retrospectively according Deauville/Lugano criteria. Endpoints: objective response rate (ORR), time to relapse (PFS) overall survival (OS).
Results
Until August 2015, 56 patients had receive therapy with 90Y-IT and completed at least 1 year of follow-up were considered to analysis; M/F 29/27 mean age 59.7 years (31-86); ECOG 0-1 94.4%. According WHO classification: follicular-NHL 44 (78.6%), mantle cell-NHL 2 (3.6%), DLCB-NHL 7 (12.5%) and MALT-NHL 3 (5.4%). Score risk distribution: low 19 (33.9%), intermediate 24 (42.9%) and advanced 13 (23.2%). 54.5% of patients were stage IV. The majority of patients received ≤2 (90.7%) previous therapy schedules and >2 (9.3%). The mean follow-up time: 53.1 months (95% CI: 12; 145). 31 (57.4%) patients received 90Y-IT as consolidation of first line therapy and 23 relapsed/refractory (42.6%). According IWG2007 criteria: ORR was 98.2 % CR: 50 (92.6%); PR 3 (5.4%) and 1 failure (1.9%) in relapsed/refractory disease. According Lugano following the recommendation of Deauville criteria about the presence of residual mass and the scale of 5 points, the response were: CR (1-2 scores or 3 scores with a reduction respect the baseline and no presence of residual disease) 46 (85.2%), presence of residual disease (scores 4-5 or mass with score 3 without a reduction respect baseline): 8 (14.8%). During follow-up 13 patients (24.1%) had relapsed, 10 were categorized as CR by IWG2007, 9 CR by Lugano and 7 CR by Deauville with a higher negative predictive value. The mean PFS: 109.6 months (95% CI: 94.8; 124.4) median NR. However for patients classified as CR by Deauville, the mean PFS was 117.1 month (102.2 – 132.0), median NR, and 40.7 (16.4 – 65.2), median 16 (6.2 – 25.7) months for the rest, fig 1. During follow up eight patients have dead, 5 of them after 55 or more months after 90Y-IT therapy. Dead were related to disease in 7 patients.
Conclusion
In our series of NHL patients treated with 90Y Ibritumomab tiuxetan, the re-assessment of response by PET/CT scan according Deauville criteria at the end of therapy shows more restrictive for CR when scale 3 combining with residual mass is considering as residual disease, improving the accuracy of CR in 7.4% and prolonged PFS in 7.5 months, respect IWG2007.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Follow-up, PET, Radioimmunotherapy
Type: Publication Only
Background
90Y-Ibritumomab-tiuxetan (90Y-IT) has become an efficient alternative therapy in non-Hodgkin Lymphoma (NHL). The staging and response assessment have changed and PET/CT scan with Deauville/Lugano criteria have become the recommended tool.
Aims
To analyse our updated information of patients treated with 90YIbritumomab/tiuxetan in our institution comparing the IWG2007 Chenson and Lugano/Deauville criteria to analyse treatment outcome.
Methods
120 NHL patients were included in a clinical protocol conducted by a multidisciplinary team and treated in the same centre. For this sub study 54 patients have been included, all of them followed by more than 12 months and the response assessed with PET/CT scan after 12 weeks out therapy using the same machine, the images were available for re-assessment retrospectively according Deauville/Lugano criteria. Endpoints: objective response rate (ORR), time to relapse (PFS) overall survival (OS).
Results
Until August 2015, 56 patients had receive therapy with 90Y-IT and completed at least 1 year of follow-up were considered to analysis; M/F 29/27 mean age 59.7 years (31-86); ECOG 0-1 94.4%. According WHO classification: follicular-NHL 44 (78.6%), mantle cell-NHL 2 (3.6%), DLCB-NHL 7 (12.5%) and MALT-NHL 3 (5.4%). Score risk distribution: low 19 (33.9%), intermediate 24 (42.9%) and advanced 13 (23.2%). 54.5% of patients were stage IV. The majority of patients received ≤2 (90.7%) previous therapy schedules and >2 (9.3%). The mean follow-up time: 53.1 months (95% CI: 12; 145). 31 (57.4%) patients received 90Y-IT as consolidation of first line therapy and 23 relapsed/refractory (42.6%). According IWG2007 criteria: ORR was 98.2 % CR: 50 (92.6%); PR 3 (5.4%) and 1 failure (1.9%) in relapsed/refractory disease. According Lugano following the recommendation of Deauville criteria about the presence of residual mass and the scale of 5 points, the response were: CR (1-2 scores or 3 scores with a reduction respect the baseline and no presence of residual disease) 46 (85.2%), presence of residual disease (scores 4-5 or mass with score 3 without a reduction respect baseline): 8 (14.8%). During follow-up 13 patients (24.1%) had relapsed, 10 were categorized as CR by IWG2007, 9 CR by Lugano and 7 CR by Deauville with a higher negative predictive value. The mean PFS: 109.6 months (95% CI: 94.8; 124.4) median NR. However for patients classified as CR by Deauville, the mean PFS was 117.1 month (102.2 – 132.0), median NR, and 40.7 (16.4 – 65.2), median 16 (6.2 – 25.7) months for the rest, fig 1. During follow up eight patients have dead, 5 of them after 55 or more months after 90Y-IT therapy. Dead were related to disease in 7 patients.
Conclusion
In our series of NHL patients treated with 90Y Ibritumomab tiuxetan, the re-assessment of response by PET/CT scan according Deauville criteria at the end of therapy shows more restrictive for CR when scale 3 combining with residual mass is considering as residual disease, improving the accuracy of CR in 7.4% and prolonged PFS in 7.5 months, respect IWG2007.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Follow-up, PET, Radioimmunotherapy
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