90-Yttrium-ibritumomab-tiuxetan is approved for treatment of rituximab-relapsed/refractory CD20+ follicular B-cell lymphoma and as consolidation therapy in untreated follicular lymphoma. Recommendations on the use of 90-yttrium-ibritumomab tiuxetan were issued in a consensus conference, sponsored by the Italian Society of Hematology and the Italian Association of Nuclear Medicine. Current concepts and scientific evidence on the use of 90-yttrium-ibritumomab-tiuxetan were evaluated by a panel of seven experts. The following key recommendations were issued. The most important exclusion criteria are: bone marrow infiltration by lymphoma cells and platelet count or neutrophil count lower than 100 × 109/L or 1.5 × 10 9/L. The most relevant indication for 90Y-ibritumomab- tiuxetan is as a single agent or following debulking chemotherapy for relapsed/refractory follicular lymphoma. 90Y-ibritumomab tiuxetan as a single agent is effective in improving the quality and duration of the response in follicular lymphoma after primary chemotherapy or immunochemotherapy. 90Y-ibritumomab-tiuxetan as a single agent has activity in relapsed/refractory mantle cell lymphoma and DLBCL, but the responses are of short duration. Its use after first line chemoimmunotherapy as consolidation therapy appears promising, particularly in elderly patients. The addition of 90Y-ibritumomab-tiuxetan to high-dose chemotherapy, such as BEAM, is feasible and may be recommended for patients with high-risk relapsed/refractory lymphoma. Subsequent lines of therapy can be successfully used in patients who relapse after radioimmunotherapy.
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