Allogeneic Transplantation of Haematopoietic Stem Cells Following Non-Myeloablative Conditioning With Melphalan, Fludarabine, Thiotepa, Rituximab and Ibritumomab Tiuxetan (Zevalin) in Patients With Aggressive Non-Hodgkin's B-Cell Lymphoma
Inclusion Criteria:
1. Written informed consent
2. Histologically confirmed B-cell lymphoma of the following subtypes:
- LBCDL
- Grade 3b follicular lymphoma
- Mantle-cell lymphoma
- Transformed B-cell lymphoma
- Burkitt lymphoma in patients not eligible for a conventional allogeneic
transplant
3. High-risk B-cell CD20+ lymphoma defined by
- Having attained less than PR after two chemotherapy lines
- Post-transplantation relapse
- Presence of disease detected through a metabolic approach (PET/CT or else
CT+PET) either before or after autologous transplantation
- Inability to collect enough stem cells for autologous transplantation
4. Stable disease at the time of transplantation
5. Age between 18 and 65
6. Performance status (ECOG) ≤ 2
7. Normal and suitable pulmonary function (DLCO ≥ 30%)
8. Left ventricular ejection fraction (LVEF) determined by ventriculography or
echocardiogram ≥ 40%
9. Normal hepatic and renal function, with creatinine ≤ 2 mg/dl and Bi ≤ 1.5 mg/dl, and
alkaline phosphatase ≤ 2.5 x UNL ; AST, ALT ≤ 2.5 x UNL (≤ 5 x UNL if hepatic
infiltration)
Exclusion Criteria:
1. Prior treatment with radiopharmaceutical agents
2. HIV-associated lymphoma
3. Presence of human anti-mouse antibodies (HAMA) or anti-chimeric antibodies (HACA)
4. Patient's inability to follow the protocol
5. Hypersensitivity to 90Y-itritumomab tiuxetan
6. Presence of severe pathologies that preclude chemotherapeutic treatment
7. Pregnant women or pregnancy risk due to inappropriate contraceptive measures
8. Breastfeeding women