No reactivation of JCV in bone marrow of follicular lymphoma patients treated front-line with rituximab plus 90y-ibritumomab tiuxetan.

摘要: Treatment with the anti-CD20 monoclonal antibody rituximab has been associated progressive multifocal leukoencephalopathy (PML) in rheumatological and nonHodgkin lymphoma patients solid organ transplant recipients [1]. PML is caused by reactivations of polyomavirus JC (JCV), early detection JCV genome peripheral blood suggested as a good surrogate marker for treatment interruption increased surveillance kidney treated multiple sclerosis natalizumab [2, 3]. Moving from evidences replication bone marrow plasma cells both after HIV-positive without PML, our group previously tested serial samples four cases found that positivity preceded blood, cerebrospinal fluid, brain biopsy [4]. Here, we systematically investigated occurrence follicular murine IgG1j mAb ibritumomab conjugated to metal chelator tiuxetan retention b emitter yttrium (Y-IT). Informed consent was obtained all being included study. All procedures followed were accordance ethical standards responsible committee on human experimentation (institutional national) Helsinki Declaration 1975, revised 2008. Twenty adult (enrolled phase I–II clinical trial Y-IT therapy standard initial advanced-stage [5]) received single-agent regimen follows: first 250 mg/m infusion given alone day 1. A second rituximab, administered 1 week later, 8 (±1), immediately 15 MBq/kg Y-IT, slow intravenous push over 10 min. Bone aspiration collected at diagnosis, restaging months ?1, ?3, ?6, ?12 Y-IT. DNA qualitative nested PCR (sensitivity: copy per 35,000 cells, similar used other investigators 3]). We could not detect any reactivation patient time point. have reported here absence upfront Although study limited follow-up, extremely high level assay sensitivity provides clinicians reassurance risk Further studies are needed confirm long-term safety relapsed or refractory maintenance therapy. D. Focosi (&) M. Pistello Department Translational Research, University Pisa, via Paradisa 2, 56124 Italy e-mail: daniele.focosi@gmail.com; d.focosi@ao-pisa.toscana.it