Yt90 Zevalin and Combination Chemotherapy (Z-CHOP)in Treating Patients With Stage II, Stage III, or Stage IV Diffuse Large B-cell Lymphoma

Study Overview
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Brief Summary
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The purpose of this study is to determine whether the treatment of Yt90 Zevalin in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone)are effective as first line treatment in patients with bulky stage II or stage III or IV diffuse large B-cell lymphoma

Detailed Description
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Radioimmunotherapy represents a significant advance over unlabeled immunotherapy for the treatment of patients with B-cell non-Hodgkin's lymphoma. The radiobiological effects associated with Yt90-labelled ibritumomab tiuxetan (Zevalin) include the induction of apoptosis and cell-cycle redistribution. The response rate tend to be higher in patients who have been treated with fewer prior therapies and Yt90-labelled ibritumomab tiuxetan may be suitable for use early in the course of therapy. Yt90-labelled ibritumomab tiuxetan has less non hematologic toxicity than chemotherapy, with only minimal alopecia, mucositis, nausea, or vomiting, and a lower incidence of infections. Yt90-labelled ibritumomab tiuxetan regimen is routinely and safely given in an outpatient setting and is completed in 7-9 days and is thus more convenient to be used.

Official Title
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Yt90Zevalin Plus CHOP, Z-CHOP

Conditions
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Diffuse Large B-cell Lymphoma

Intervention / Treatment
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* Drug: Yttrium 90 -labeled ibritumomab tiuxetan (Zevalin)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically confirmed CD20 positive diffuse large B-cell lymphoma with bulky stage II or stage III or stage IV Bidimensionally measurable disease Performance status Zubrod 0-2 Less than 20,000/mcL circulating lymphoid cells on WBC differential count No clinical evidence of CNS involvement, no prior diagnosis of indolent lymphoma, no histologic transformation Ejection fraction more than or equal to 45% by MUGA or no significant abnormality by echocardiogram Fertile patients with effective contraception method No other malignancy within past 5 years except adequately treated basal cell or squamous cell skin cancer, stage I or II cancer in complete remission, or carcinoma in situ of cervix No HIV positive, no prior solid organ transplantation No prior antibody therapy, chemotherapy, radiotherapy for lymphoma Exclusion Criteria: Serum creatinine ot bilirubin more than 2.5 X ULN unless due to lymphoma Active uncontrolled infection Concurrent severe and/or uncontrolled medical disease which could compromise participation in the study Patients with more than 25% infiltrated bone marrow Patients with platelet counts less than 100,000/mcL or neutrophil counts less than 1,500/mcL

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Yttrium 90 -labeled ibritumomab tiuxetan (Zevalin)|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 2-year progression-free survival and overall survival of patients |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Response rate (partial response, complete unconfirmed response, and complete response)in patients |  |  | 
| 2-year progression-free survival, overall survival and response rate in BCL-2 positive patients |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Zevalin, Zevalin plus CHOP, Diffuse large B-cell lymphoma, First line Diffuse large B-cell lymphoma