array:24 [ "pii" => "S2253808916300854" "issn" => "22538089" "doi" => "10.1016/j.remnie.2016.10.002" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "808" "copyright" => "Elsevier España, S.L.U. and SEMNIM" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Med Nucl Imagen Mol. 2017;36:13-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "formatos" => array:2 [ "HTML" => 1 "PDF" => 1 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S2253654X16300312" "issn" => "2253654X" "doi" => "10.1016/j.remn.2016.05.004" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "808" "copyright" => "Elsevier España, S.L.U. y SEMNIM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Med Nucl Imagen Mol. 2017;36:13-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 572 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 346 "PDF" => 220 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>" "titulo" => "Radioinmunoterapia en el linfoma no Hodgkin, posicionamiento, seguridad y eficacia de <span class="elsevierStyleSup">90</span>Y-ibritumomab. Experiencia y seguimiento a los 10 años" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "19" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Radioimmunotherapy for non-Hodgkin's lymphoma; positioning, safety, and efficacy of 90Y-Ibritumomab. 10 years of experience and follow-up" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 886 "Ancho" => 1639 "Tamanyo" => 62126 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Momento de recuperación y necesidad de transfusión.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Martínez, M. Martínez-Ramirez, D. Martínez-Caballero, P. Beneit, J. Clavel, G. Figueroa, J. Verdú" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Martínez" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Martínez-Ramirez" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Martínez-Caballero" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Beneit" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Clavel" ] 5 => array:2 [ "nombre" => "G." "apellidos" => "Figueroa" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Verdú" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2253808916300854" "doi" => "10.1016/j.remnie.2016.10.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808916300854?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X16300312?idApp=UINPBA00004N" "url" => "/2253654X/0000003600000001/v1_201612291510/S2253654X16300312/v1_201612291510/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2253808916301021" "issn" => "22538089" "doi" => "10.1016/j.remnie.2016.07.009" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "829" "copyright" => "Elsevier España, S.L.U. and SEMNIM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Med Nucl Imagen Mol. 2017;36:20-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "<span class="elsevierStyleSup">18</span>F-FDG PET/CT and sentinel lymph node biopsy in the staging of patients with cervical and endometrial cancer. Role of dual-time-point imaging" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "20" "paginaFinal" => "26" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "PET/TC con <span class="elsevierStyleSup">18</span>F-FDG y biopsia del ganglio centinela en la estadificación de pacientes con cáncer de cérvix y endometrio. Utilidad de la imagen dual-time-point" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2646 "Ancho" => 3333 "Tamanyo" => 353959 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart. Coloured cells indicate false negative cases for SLN biopsy (blue) and PET/CT (red) and false positive cases for PET/CT (green). SLN<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>sentinel lymph node. LND<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>lymph node dissection (lymphadenectomy).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Mayoral, P. Paredes, B. Domènech, P. Fusté, S. Vidal-Sicart, A. Tapias, A. Torné, J. Pahisa, J. Ordi, F. Pons, F. Lomeña" "autores" => array:11 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Mayoral" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Paredes" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Domènech" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Fusté" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Vidal-Sicart" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Tapias" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Torné" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Pahisa" ] 8 => array:2 [ "nombre" => "J." "apellidos" => "Ordi" ] 9 => array:2 [ "nombre" => "F." "apellidos" => "Pons" ] 10 => array:2 [ "nombre" => "F." "apellidos" => "Lomeña" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808916301021?idApp=UINPBA00004N" "url" => "/22538089/0000003600000001/v1_201612291502/S2253808916301021/v1_201612291502/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2253808916300866" "issn" => "22538089" "doi" => "10.1016/j.remnie.2016.10.003" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "814" "copyright" => "Elsevier España, S.L.U. and SEMNIM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Med Nucl Imagen Mol. 2017;36:7-12" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 3 "PDF" => 1 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Recombinant human thyrotropin stimulation prior to <span class="elsevierStyleSup">131</span>I therapy in toxic multinodular goiter with low radioactive iodine uptake" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "12" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estimulación previa con TSH recombinante humana previo al tratamiento con 131I en pacientes con bocio multinoduloar tóxico de baja captación" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1257 "Ancho" => 2507 "Tamanyo" => 248889 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Study protocol.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.J. Azorín Belda, A. Martínez Caballero, G.C. Figueroa Ardila, M. Martínez Ramírez, C.A. Gómez Jaramillo, J.I. Dolado Ardit, J. Verdú Rico" "autores" => array:7 [ 0 => array:2 [ "nombre" => "M.J." "apellidos" => "Azorín Belda" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Martínez Caballero" ] 2 => array:2 [ "nombre" => "G.C." "apellidos" => "Figueroa Ardila" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Martínez Ramírez" ] 4 => array:2 [ "nombre" => "C.A." "apellidos" => "Gómez Jaramillo" ] 5 => array:2 [ "nombre" => "J.I." "apellidos" => "Dolado Ardit" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Verdú Rico" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808916300866?idApp=UINPBA00004N" "url" => "/22538089/0000003600000001/v1_201612291502/S2253808916300866/v1_201612291502/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Radioimmunotherapy for non-Hodgkin's lymphoma: positioning, safety, and efficacy of <span class="elsevierStyleSup">90</span>Y-ibritumomab. 10 years of experience and follow-up" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "19" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Martínez, M. Martínez-Ramirez, D. Martínez-Caballero, P. Beneit, J. Clavel, G. Figueroa, J. Verdú" "autores" => array:7 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Martínez" "email" => array:2 [ 0 => "martinez_ant@gva.es" 1 => "amcaballero4@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Martínez-Ramirez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "D." "apellidos" => "Martínez-Caballero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Beneit" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "J." "apellidos" => "Clavel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "G." "apellidos" => "Figueroa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "J." "apellidos" => "Verdú" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Universitario San Juan de Alicante, Alicante, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Hematología, Hospital Universitario San Juan de Alicante, Alicante, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Radioinmunoterapia en el linfoma no Hodgkin: posicionamiento, seguridad y eficacia de <span class="elsevierStyleSup">90</span>Y-ibritumomab. Experiencia y seguimiento a los 10 años" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 889 "Ancho" => 1646 "Tamanyo" => 55561 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Time to recovery and need for blood transfusion.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Non-Hodgkin's lymphoma (NHL) is the most frequent hematological tumor, representing 5% of all cancers in adults. In the last years, it has remained in seventh place in relation to incidence by cancer type in both men and women. The incidence of NHL in Spain is 12.3 cases per 100,000<span class="elsevierStyleHsp" style=""></span>men/year and 10.8 cases per 100,000 women. With regard to mortality it is in ninth position in tumor-related death, representing 3% of the total number of deaths by cancer. The general rate of relative 5-year survival in patients with NHL is 69%, being 58% at 10 years. The mortality rate has fallen since the 90s demonstrating an improvement in the efficacy of the treatment in NHL.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Diffuse large B cell lymphoma (DLBCL) is the most frequent type of NHL followed by follicular lymphoma. Treatment varies widely and depends on the stage of the cancer and histological subtype. Radiotherapy or chemo-radiotherapy may be considered as adequate treatment in stage I and II indolent follicular lymphomas, achieving 10-year survival rates of greater than 50.<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2,3</span></a> In advanced stages III and IV the treatment may vary from “wait and see” without treatment to chemotherapy, radiotherapy, biological therapies or radioimmunotherapy (RIT).<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The survival of patients presenting disease progression largely depends on the follicular lymphoma international prognostic index (FLIPI). In cases of high risk 5-year survival would be less than 30% and in cases of low-intermediate risk survival would probably be greater than 80%.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The criteria most commonly used to decide whether a patient should be treated or not are the modified Groupe d’Etude des Lymphomes Folliculaires (GELF)<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> criteria which include high tumor bulk >7<span class="elsevierStyleHsp" style=""></span>cm, <span class="elsevierStyleItalic">B</span> symptoms, elevation in lactate dehydrogenase (LDH) or serum β2 microglobulin levels, involvement of more than 2 lymph node groups, splenomegaly, compressive syndrome, pleural or peritoneal effusion and cytopenia related to bone marrow involvement.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Radioimmunotherapy in indolent NHL is based on the use of conjugated monoclonal antibodies with a radioisotope in a radiotracer. This association produces a double effect on the lymphocytes expressing specific receptors by the combined effect of beta radiation and the antibody. The first studies were performed with <span class="elsevierStyleSup">131</span>I-tositumomab and later with <span class="elsevierStyleSup">90</span>Y-ibritumomab<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> (Zevalin<span class="elsevierStyleSup">®</span>). The latter is an immunoconjugate consisting of a type IgG1 kappa murine recombinant monoclonal antibody specific for the CD20+ antigen of malignant and normal B lymphocytes which is covalently bound with the chelate tiuxetan which provides stability to the labeling. Yttrium-90 (<span class="elsevierStyleSup">90</span>Y) emits beta radiation and has a physical half-life of 64<span class="elsevierStyleHsp" style=""></span>h. This radiotracer alters the DNA and produces cellular radiolysis within an action radius of 5<span class="elsevierStyleHsp" style=""></span>mm, having a double immunological and radioactive cross fire effect.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> The systemic distribution of <span class="elsevierStyleSup">90</span>Y simultaneously achieves multiple localizations of the disease with a dose of 16–18<span class="elsevierStyleHsp" style=""></span>Gy being absorbed by the tumor with limited radiation exposure to healthy tissue due to its limited penetration or trajectory. This radiotracer is physiologically eliminated in the urine and the gastrointestinal tract, having an effective biological half-life of 28<span class="elsevierStyleHsp" style=""></span>h.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> A great advantage of this radiotracer is that since it only presents beta and not gamma radiation, isolation in a lead shielded room is not necessary and thus, hospitalization is not required, although it is recommended to collect the first excretions in a Nuclear Medicine therapy unit.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The current indications for the use of Zevalin<span class="elsevierStyleSup">®</span> are: (1) treatment of adult patients with relapse of follicular CD20+ B cell NHL or refractory to rituximab and (2) consolidation treatment following induction of remission in previously non-treated patients with follicular lymphoma. Zevalin<span class="elsevierStyleSup">®</span> is contraindicated in patients presenting hypersensitivity to ibritumomab, tiuxetan, yttrium chloride or rituximab and during pregnancy and breast feeding. Neither should it be administered to patients with: bone marrow infiltration >25%, a platelet count <100,000/mm<span class="elsevierStyleSup">3</span> (<150,000/mm<span class="elsevierStyleSup">3</span> in consolidation treatment) and a neutrophil count <1500/mm<span class="elsevierStyleSup">3</span>.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Zevalin<span class="elsevierStyleSup">®</span> is a relatively safe radiotracer. Hematological toxicity is very frequent but is usually transitory and can usually be managed without complications. Non-hematological symptoms such as asthenia or respiratory infections are common but are usually mild and self-limiting.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Taking into account the great variability in the treatments used in indolent NHL and the scarce literature on the use of RIT is Spain, the main objectives of the present study were to describe our clinical experience and evaluate the therapeutic position, effectiveness and safety of the use of <span class="elsevierStyleSup">90</span>Y-ibritumomab in patients with NHL.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material and method</span><p id="par0045" class="elsevierStylePara elsevierViewall">We performed a retrospective, observational study of patients with NHL receiving treatment with <span class="elsevierStyleSup">90</span>Y-ibritumomab (Zevalin<span class="elsevierStyleSup">®</span>) in the Department of Nuclear Medicine of the reference hospital for this treatment. The first patient was treated on February 11, 2005, the year this treatment was approved by the Spanish Agency of Medications and Health Care Products. Thereafter, patients were consecutively treated and followed until September 2015.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Patients were selected after presentation to the Committee of Hematological Tumors of the Hospital Universitario San Juan in Alicante, Spain which is composed of medical oncologists, radio-oncologists, hematologists, pathologists and nuclear medicine physicians, among others. The patients included in the study received the following treatment schedule:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">–</span><p id="par0055" class="elsevierStylePara elsevierViewall">Day 0: rituximab iv 250<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span> in the hospital of origin.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">–</span><p id="par0060" class="elsevierStylePara elsevierViewall">Day 7: rituximab iv 250<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>individualized intravenous dose of Zevalin<span class="elsevierStyleSup">®</span>.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">–</span><p id="par0065" class="elsevierStylePara elsevierViewall">Biweekly hematological control during 3 months (consultation in Nuclear Medicine).</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">–</span><p id="par0070" class="elsevierStylePara elsevierViewall">Evaluation of response: 4–6 months (consultation in Oncology/Hematology).</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">–</span><p id="par0075" class="elsevierStylePara elsevierViewall">Follow-up every 6 months (consultation in Oncology/Hematology). Annual controls if complete response (CR) is maintained. End of follow-up September 2015.</p></li></ul></p><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Dose administration</span>: Individualized intravenous dose of Zevalin<span class="elsevierStyleSup">®</span>. The dose was adjusted to 14.8<span class="elsevierStyleHsp" style=""></span>MBq/kg (0.4<span class="elsevierStyleHsp" style=""></span>mCi/kg) if the platelet count was >150,000<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">3</span>, and with platelet counts <150,000<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">3</span> the dose was reduced to 11.1<span class="elsevierStyleHsp" style=""></span>MBq/kg (0.3<span class="elsevierStyleHsp" style=""></span>mCi/kg).</p><p id="par0085" class="elsevierStylePara elsevierViewall">Patients were grouped based on the type of NHL, the histological grade, the FLIPI index, staging and the chemotherapy lines received prior to treatment with Zevalin<span class="elsevierStyleSup">®</span>. We evaluated the concordance with the recommendations of the guidelines of clinical practice of the National Comprehensive Cancer Network (NCCN) version 4.2015,<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> the guidelines of the European Society for Medical Oncology (ESMO)<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> and those of the Spanish Society of Hematology.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">We measured therapeutic effectiveness as the response to treatment at 4–6 months using CT, FDG-PET, magnetic resonance, and ultrasonography imaging techniques to determine CR, partial response (PR), stable disease (SD) and disease progression. Likewise, we evaluated progression-free survival (PFS) and overall survival (OS) at the end of follow-up.</p><p id="par0095" class="elsevierStylePara elsevierViewall">We assessed hematological and general toxicity using the Common Terminology Criteria for Adverse Events (CTCAE v 4.0) classification scale.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Data analysis was performed using the statistical model of the SPSS 20 program, estimating the survival curves according to the Kaplan–Meier model.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Positioning</span><p id="par0105" class="elsevierStylePara elsevierViewall">Treatment with <span class="elsevierStyleSup">90</span>Y-ibritumomab was requested for 26 patients, 21 of whom were included in the final analysis. Five patients did not receive treatment due to their general poor status (severe bone marrow involvement in 2 and death in the remaining 3). <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the principal demographic and clinical data of the patients studied. Of all the patients treated only 2 were over the age of 70 years (recommendation 2 B of the NCCN). In 19% of the patients the clinical presentation of the disease was staged as early I–II NHL, with 81% in advanced stages III–IV. One patient presented stage III-AS. Six patients presented B symptoms, 3 in stage II, 2 in stage IV and 1 in stage II. Three or more lymph node chains were affected in 60% of the patients, and almost one third presented FLIPI >2 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Prior to treatment with <span class="elsevierStyleSup">90</span>Y-ibritumomab, 23% of the patients had received one line of chemotherapy while 52% had received 3 lines or more. The histological types were: follicular lymphoma in14 patients, transformed follicular NHL in 2, mantel cell NHL in 3, and DLBCL NHL in 2.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Three kinds of treatment were applied with different objectives: (a) <span class="elsevierStyleItalic">refractory NHL</span> in 12 patients (10 follicular NHL, 1 transformed follicular NHL and 1 DLBCL NHL); (b) <span class="elsevierStyleItalic">consolidation of response</span> in 7 patients (3 mantel cell NHL, 4 follicluar NHL), and (c) <span class="elsevierStyleItalic">transplant conditioning</span> with Z-BEAM in 2 patients (1 DLBCL and 1 transformed follicular lymphoma).</p><p id="par0115" class="elsevierStylePara elsevierViewall">Approval from the health care authorities was obtained for the use of Zevalin<span class="elsevierStyleSup">®</span> as a medication for special needs in patients with mantel cell NHL, transformed follicular NHL, DLBCL NHL and transplant conditioning since these cases were not included among the previously approved indications.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Safety</span><p id="par0120" class="elsevierStylePara elsevierViewall">No patient presented any adverse reaction in the first control at 2 weeks; adverse effects initiated at around 4 weeks after treatment. <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> describes the adverse effects presented, including thrombocytopenia in 15 patients (71%), leucopenia in 12 (57%) and other non-hematological adverse effects in 80%. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the grades of hematotoxicity presented, with grade 4 thrombocytopenia (according to CTCAE v 4.0)<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> in 4 patients, representing 19% of the cases, 45% of whom recovered in less than one month. No patient developed grade 4 neutropenia, but grade 3 was observed in 5 patients. Only 14% of the patients required blood transfusion, mainly of platelets (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the non-hematologic adverse effects observed from the initiation of treatment to the end of follow-up, most of which were mild and transitory. One patient who had also been previously treated with chemotherapy for breast cancer presented a late myelodysplastic syndrome. Two patients developed a second neoplasm during follow-up: 1 rectal cancer and the other prostate cancer.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Effectiveness of the treatment</span><p id="par0130" class="elsevierStylePara elsevierViewall">The mean dose of <span class="elsevierStyleSup">90</span>Y-ibritumomab used was 1017<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>148<span class="elsevierStyleHsp" style=""></span>MBq [27.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mCi; range 740–1184<span class="elsevierStyleHsp" style=""></span>MBq (20–32)]. No patient received a dose greater than 1184<span class="elsevierStyleHsp" style=""></span>MBq according to the indications of the radiotracer. All patients received individualized doses of 14.8<span class="elsevierStyleHsp" style=""></span>MBq/kg (0.4<span class="elsevierStyleHsp" style=""></span>mCi/kg) except one patient with mild thrombocytopenia (platelet count 127,000<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">3</span>), who was given a dose of 11.1<span class="elsevierStyleHsp" style=""></span>MBq/kg (0.3<span class="elsevierStyleHsp" style=""></span>mCi/kg).</p><p id="par0135" class="elsevierStylePara elsevierViewall">Response and clinical evolution were evaluated at 3–4 months by CT and PET/CT with <span class="elsevierStyleSup">18</span>F-FDG. Sixteen patients showed overall response (76.2%): 15 with CR (71.4%) and 1 with PR (4.8%). Four patients (19%) did not respond, showing progression with 1 follicular lymphoma previously treated with 5 lines of chemotherapy, 1 mantel cell lymphoma with 4 lines of chemotherapy and unsuccessful transplantation, 1 aggressive mantel cell lymphoma with 1 chemotherapy line unable to undergo transplantation and lastly, 1DLBCL lymphoma receiving <span class="elsevierStyleSup">90</span>Y-ibritumomab for transplant conditioning with 5 lines of previous chemotherapy. It was decided to administer new treatment in 1 patient with bulky transformed follicular lymphoma and 3 previous chemotherapy lines who did not respond and remained with stable disease. This patient died at 8 months. <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the different types of response to <span class="elsevierStyleSup">90</span>Y-ibritumomab.</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Zevalin<span class="elsevierStyleSup">®</span> was administered in 3 treatment modalities:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">a.</span><p id="par0145" class="elsevierStylePara elsevierViewall">In 12 <span class="elsevierStyleItalic">refractory/recurrent lymphomas</span>, and in the evaluation of response at 3–4 months the following was achieved: CR in 9 patients, PR in 1 DLBCL, SD in 1 patient with bulky transformed follicular lymphoma and progression in 1 follicular lymphoma previously treated with 5 lines of chemotherapy.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">b.</span><p id="par0150" class="elsevierStylePara elsevierViewall">In 7 <span class="elsevierStyleItalic">consolidation</span> treatments (4 follicular lymphomas and 3 mantel cell lymphomas) at 3–4 months we observed that 3 patients with PR (2 follicular lymphomas and 1 mantel cell lymphoma) achieved CR; 2 patients with follicular lymphoma maintained CR, and lastly, 2 mantel cell lymphomas progressed.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">c.</span><p id="par0155" class="elsevierStylePara elsevierViewall">In 2 <span class="elsevierStyleItalic">transplant conditioning</span> treatments: 1 patient with transformed follicular lymphoma who successfully received an allogenic transplant achieved remission until the end of follow-up, and 1 patient with DLBCL presented progression despite transplantation and died at 24 months.</p></li></ul></p><p id="par0160" class="elsevierStylePara elsevierViewall">The median duration of overall response was 45.5 months and 60 months for CR (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). Of the 15 patients presenting CR, 7 (46%) remained in remission until the end of follow-up and the mean time to recurrence in the remaining patients was 25 months, with the earliest relapse developing at 16 months. <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> shows the characteristics of the 7 patients who remained in remission until the end of follow-up. The normality of the serum LDH levels in all these patients was of note while the LDH levels were elevated in 6 (43%) of the remaining 14 patients.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">In addition to patients with follicular NHL, Zevalin<span class="elsevierStyleSup">®</span> was used in 7 patients not fulfilling the usual indications for this treatment: 2 transformed follicular lymphomas, 2 DLBCL and 3 patients with mantel cell lymphoma. Of the 2 patients with transformed follicular NHL, 1 with FLIPI 4 bulky refractory follicular lymphoma treated with 3 lines of chemotherapy died at 8 months while the other patient under transplant conditioning in a clinical trial underwent successful graft implantation and was in remission. Of the 2 patients with DLBCL, 1 had refractory lymphoma and achieved PR followed by progression, and the other received transplant conditioning, was not transplanted and died. Of the 3 patients with mantel cell lymphoma under consolidation of response, 2 presented disease progression and 1 achieved PR followed by CR.</p><p id="par0170" class="elsevierStylePara elsevierViewall">The median follow-up was 70 months. Six patients died during this period: 4 as a result of the evolution of NHL and 2 due to complications (pneumonia and post-transplant sepsis). The OS was 96<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9 months and PFS was 54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11 months (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>).</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Positioning</span><p id="par0175" class="elsevierStylePara elsevierViewall">We could not quantify the number of patients with follicular NHL treated with other chemotherapy lines who might have been treated with Zevalin<span class="elsevierStyleSup">®</span> because of strategic impossibilities since our institution is a Nuclear Medicine reference center and the patients are referred from all the hospitals in our region. However, although we do not know the percentage of real use of Zevalin<span class="elsevierStyleSup">®</span> in follicular NHL, we do know in what situation this treatment was requested among the patients treated. Thus, as shown in Results most of the patients (52.3%) were treated with 3 or more lines of chemotherapy. On the other hand, the recommendation of use in patients over 70 years of age does not seem to have been followed since the rate of patients of this age in the present study was very low (14% of the total).<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11,12</span></a> The initial stage in 17 patients (80.9%) was II–IV which is the most usual form of presentation in indolent NHL. With regard to the treatment modality, most treatments were for patients with recurrent/refractory lymphoma (57%) and consolidation of response in 7 patients (33.3%), 3 of whom had mantel cell NHL. Lastly, it seems that treatments with Zevalin<span class="elsevierStyleSup">®</span> for transplant conditioning with Z-BEAM, which are not currently indicated in Spain, are on the rise.</p><p id="par0180" class="elsevierStylePara elsevierViewall">The NCCN guidelines recommend RIT as the first therapeutic line in elderly patients with poor status and as a second or subsequent line in transformed lymphomas.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> In the present series, Zevalin<span class="elsevierStyleSup">®</span> was not used as first line therapy in elderly patients but rather was used in patients who had received more than 2 previous chemotherapy lines. It was, however, used as second line therapy as recommended by the NCCN. The NCCN guidelines also recommend RIT in transformed follicular lymphoma with or without response to chemotherapy, although this indication is not approved in our country. We treated 2 patients with transformed NHL, 1 of whom died at 8 months and the other obtained PR and was included in a clinical transplant trial. The use of RIT is also recommended by the NCCN and other authors for consolidation therapy.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11,15</span></a> Indeed, in the present study RIT was used in 33.3% of the patients receiving consolidation treatment, although not only in follicular lymphoma but also mantel cell lymphoma, thereby coinciding with some of the NCCN recommendations.</p><p id="par0185" class="elsevierStylePara elsevierViewall">The present study did not follow the 2014 ESMO guidelines which recommended the use of RIT, albeit in second line therapy, in older patients with comorbidity in whom chemotherapy is not appropriate. In addition, these guidelines consider RIT inferior to rituximab in consolidation-maintenance treatments.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Lastly, the GPC-LPF guidelines (Spanish Society of Hematology) of 2011 suggest the possibility of using rituximab in monotherapy in induction treatment in patients with low risk, with the use of RIT as an alternative therapy, albeit still in an experimental phase. This, however, is not the case since it is not used as induction therapy. In addition, in the treatment of relapse RIT is not considered, and these guidelines do not seem to favor the use of RIT.</p><p id="par0195" class="elsevierStylePara elsevierViewall">Therefore, in the current guidelines the use of RIT with Zevalin<span class="elsevierStyleSup">®</span> seems to be more in agreement with American schedules than with European or Spanish recommendations. On the other hand, RIT is used in late phase following many previous lines of chemotherapy, perhaps avoiding the use of radiation, despite it having shown to be quite safe and effective with fewer adverse effects than alkylating agents.</p><p id="par0200" class="elsevierStylePara elsevierViewall">In addition to patients with follicular lymphoma, treatment with Zevalin<span class="elsevierStyleSup">®</span> was used in a case not included in the established indications. This was a patient with DLBCL included in a clinical trial and the aim of the treatment was transplant conditioning with Z-BEAM and to determine new transplant preparation modalities.</p><p id="par0205" class="elsevierStylePara elsevierViewall">This treatment was also used in 3 patients with mantel cell lymphoma for consolidation of response, with 2 patients presenting relapse at 6 and 24 months while the remaining patient currently remains free of disease.</p><p id="par0210" class="elsevierStylePara elsevierViewall">It therefore seems that the positioning of RIT is still not completely defined making further randomized multicenter studies necessary.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Safety</span><p id="par0215" class="elsevierStylePara elsevierViewall">In relation to hematotoxicity, in their first study on Zevalin<span class="elsevierStyleSup">®</span> in 54 patients with follicular lymphoma, Witzig et al. detected higher rates of grade IV neutropenia and lower rates of grade IV thrombocytopenia (35% and 9%, respectively) than in our study (0% and 19%, respectively). These authors included a large proportion of patients with bone marrow involvement, previous radiotherapy and all had been treated with more than 4 lines of chemotherapy.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> Moreover, despite lower individualized doses (0.3<span class="elsevierStyleHsp" style=""></span>mCi/kg) in patients with thrombocytopenia prior to treatment with Zevalin<span class="elsevierStyleSup">®</span> and with bone marrow involvement <25%, a rate of grade IV thrombocytopenia of 13% has been reported with recovery within 6–8 weeks, similar to what occurred in our group and apparently without affecting the effectiveness of the treatment.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> Only 14% of our patients required blood transfusion to correct hematotoxicity, being somewhat lower than in other series such as that by Witzig et al. in 350 patients, 20% of whom received blood transfusion,<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> demonstrating that toxicity is quite common.</p><p id="par0220" class="elsevierStylePara elsevierViewall">With regard to non-hematological adverse effects such as asthenia, nausea, colds etc. our patients presented mild, transitory effects similar to what has been described in other studies.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> However, although none of our patients presented severe infections as suggested in the product specifications, a large number of mild, manageable and transitory upper airway infections were observed.</p><p id="par0225" class="elsevierStylePara elsevierViewall">In relation to the appearance of second neoplasms and the myelodysplastic syndrome described in the literature,<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16,18,20</span></a> 2 of our patients developed new neoplasms (rectal and prostate cancer) following treatment. These neoplasms are not among those most associated with follicular NHL, which are lung cancer and melanoma according to the Surveillance, Epidemiology and End Results registries.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> In addition, only 1 patient developed a myelodysplastic syndrome during follow-up, with a frequency similar to previous studies and lower than rates described after chemotherapy with or without rituximab.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> It therefore seems that the oncological complications detected are not attributable to Zevalin<span class="elsevierStyleSup">®</span>.</p><p id="par0230" class="elsevierStylePara elsevierViewall">Thus, Zevalin<span class="elsevierStyleSup">®</span> is well tolerated, may produce generally reversible cytopenias, the severity of which is related to bone marrow involvement and multiple previous chemotherapy lines. The cytopenias were produced with a median nadir of 6–8 weeks with patient recovery within approximately one month. It is therefore recommended to perform blood counts at least every 2 weeks post-treatment during 8–10 weeks with evaluation of the need for blood transfusion. On the other hand, while cases of myelodysplastic syndrome are rare, they should be considered. Non-hematological adverse effects are mild and easily managed.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Effectiveness</span><p id="par0235" class="elsevierStylePara elsevierViewall">Overall, patients showed good response to treatment with Zevalin<span class="elsevierStyleSup">®</span>, with a rate of overall response of 76.2%, almost all of which involved CR (71.4%). These rates are promising and are greater than those reported in the first studies by Witzig et al., with CR rates of 15%. Nonetheless, the patients in the Witzig group presented worse prognostic indices (bulky, more than 4 lines of chemotherapy, etc.). Indeed, our results are more similar to later studies by these authors including a larger number of patients with rates of overall response of 80% and CR of 30%<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16,19</span></a> or the study by Wiseman et al., reporting rates of CR of 44% and PR of 40%.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">Zevalin<span class="elsevierStyleSup">®</span> has shown to be very effective. Thus, on comparing Zevalin<span class="elsevierStyleSup">®</span> with other drugs in monotherapy in patients with refractory follicular lymphoma the rates of response are higher than with bendamustin,<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> idelalisib<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> or lenalidomide.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> However, Zevalin<span class="elsevierStyleSup">®</span> is not the first choice treatment despite the results of these studies. Indeed, our data also show a high rate of effectiveness with RIT.</p><p id="par0245" class="elsevierStylePara elsevierViewall">In a recent study using Zevalin<span class="elsevierStyleSup">®</span> as first line therapy in non-treated patients, up to 87% of overall response was achieved with CR of 56% and long-term response in 35% of the patients.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> It therefore seems that this drug is useful for achieving complete long-term response if used in the earliest phases of the disease. Likewise, 33% (7 out of 21) of our patients presented long-term response/disease remission, despite Zevalin<span class="elsevierStyleSup">®</span> not being used as the first line treatment.</p><p id="par0250" class="elsevierStylePara elsevierViewall">As occurred in our study and similar to previous reports, patients presenting CR had a higher probability of presenting longer response, being even greater than that described for rituximab<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16,26</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>). Likewise, similar to what has been reported in other studies, we found that in patients with long-term response and in remission, LDH levels were not elevated and thus, future studies should evaluate the true prognostic value of LDH levels in response to treatment.<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25,26</span></a></p><p id="par0255" class="elsevierStylePara elsevierViewall">Among the 7 patients in our study receiving consolidation therapy, 3 progressed from PR to CR and 2 remained with CR, thereby confirming the trend of the effectiveness of Zevalin<span class="elsevierStyleSup">®</span> in this setting. Indeed, the international FIT study reported conversion to CR in up to 77% of the patients with the effectiveness in PFS tripling at 8 years of follow-up, thereby leading to the introduction of Zevalin<span class="elsevierStyleSup">®</span> in consolidation programs.<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15,27</span></a></p><p id="par0260" class="elsevierStylePara elsevierViewall">The survival rates obtained in our study, with medians of OS of 96 months and PFS of 54 months, are higher than those described by Witzig et al. in their first studies likely due to the characteristics of their patients.<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16,19</span></a> Other authors have reported a lower median time to progression or PFS compared to the present study, probably due to the length of follow-up and the high rate of CR of our patients.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17,18</span></a> On the other hand, the rates of response and survival with Zevalin<span class="elsevierStyleSup">®</span> seem to be better than those described in the literature in independent studies with other drugs such as bendamustin, idelalisib and lenalidomide.<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">22–24</span></a></p><p id="par0265" class="elsevierStylePara elsevierViewall">It should be pointed out that the quality of life of our patients during RIT was not evaluated using a standard test. Nonetheless, taking into account the convenience of a single treatment dose, without hospital admission and manageable secondary effects patients perceive RIT treatment with good indices of quality of life.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a></p><p id="par0270" class="elsevierStylePara elsevierViewall">Finally, other treatments with RIT remain to be validated such as repeated fractionated doses which seem to achieve higher rates of response and survival (overall response of 96%, with higher CR of 70%, OS at 3 years of 95% and PFS of 58%)<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> or transplantation conditioning with Z-BEAM which is currently being evaluated in ongoing studies on transplantation in patients with DLBCL.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a></p><p id="par0275" class="elsevierStylePara elsevierViewall">The limitations of this study are that it was a retrospective study in a small number of patients who made up a heterogeneous group who were difficult to follow because of their referral from different hospitals. Randomized, multicenter studies are needed to compare the use of Zevalin<span class="elsevierStyleSup">®</span> with other therapies such as R-bendamustin, among others, in first line therapy and perhaps with repeated doses of Zevalin<span class="elsevierStyleSup">®</span>.</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusions</span><p id="par0280" class="elsevierStylePara elsevierViewall">Radioimmunotherapy is used as a third or even later treatment option in refractory follicular NHL and is frequently indicated in cases other than those recommended in the clinical guidelines. In the present study a high rate of CR and long-term remission was achieved, with frequent, albeit manageable, hematologic toxicity. The results of this demonstrate that RIT is effective, well tolerated, and safe and is probably underused.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0285" class="elsevierStylePara elsevierViewall">None of the authors declares any conflict of interest.</p><p id="par0290" class="elsevierStylePara elsevierViewall">This study did not receive any financial support.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres783230" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec782194" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres783231" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Método" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec782193" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and method" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Positioning" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Safety" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Effectiveness of the treatment" ] ] ] 7 => array:3 [ "identificador" => "sec0035" "titulo" => "Discussion" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Positioning" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Safety" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Effectiveness" ] ] ] 8 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflict of interests" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-03-28" "fechaAceptado" => "2016-05-06" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec782194" "palabras" => array:4 [ 0 => "Lymphoma" 1 => "Non-Hodgkin" 2 => "Radioimmunotherapy" 3 => "Ibritumomab" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec782193" "palabras" => array:4 [ 0 => "Linfoma" 1 => "No Hodgkin" 2 => "Radioinmumoterapia" 3 => "Ibritumomab" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Radioimmunotherapy (RIT) is one of the therapies directed against molecular targets in non-Hodgkin's lymphoma (NHL).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To evaluate the positioning, safety, and effectiveness of RIT with <span class="elsevierStyleSup">90</span>Y-ibritumomab in NHL patients.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A retrospective study was conducted on patients with NHL who received RIT with <span class="elsevierStyleSup">90</span>Y-ibritumomab. An evaluation was made of the concordance with clinical guidelines, toxicity as rated by the Common Terminology Criteria for Adverse Events (CTCAE), and effectiveness was assessed based on response to treatment, overall survival (OS), and progression-free survival (PFS).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">RIT was requested in 26 patients, of whom 21 (11 women, mean age 56<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 years) were included in the study, with the following distribution: Follicular NHL, 67%, Mantle NHL, 14%, Diffuse large B-cell NHL, 9.5%, and Transformed NHL 9.5%. Twelve patients with refractory NHL, 7 for consolidation response, and 2 transplant conditioning, were treated. Adverse effects were observed in 71% of patients, which were usually manageable and transient, and with the most common being thrombocytopenia. At 3–4 months, overall response rate was 76.2% (71.4% complete and 4.8% partial response), and 19% had progression of disease. With a median follow-up of 70 months, the OS was 96<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8 months, and the PFS was 54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11 months.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">RIT showed a moderate correlation with clinical guidelines, and is probably underused. Adverse effects were common, mild, and manageable. The data show a high complete response rate and an increase in the OS and PFS.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La radioinmunoterapia (RIT) es uno de los tratamientos dirigidos contra dianas moleculares del linfoma no Hodgkin (LNH).</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Evaluar el posicionamiento de la RIT con <span class="elsevierStyleSup">90</span>Y-ibritumomab en pacientes con LNH, así como su seguridad y efectividad.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Método</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de pacientes con LNH que recibieron RIT con <span class="elsevierStyleSup">90</span>Y-ibritumomab. Se evaluaron la concordancia con las guías clínicas, la toxicidad según la clasificación Common Terminology Criteria for Adverse Events (CTCAE) y la efectividad en función de la respuesta al tratamiento y de la supervivencia global (SG) y la supervivencia libre de progresión (SLP).</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se solicitó RIT en 26 pacientes, de los que 21 (11 mujeres, edad media ± desviación estándar 56<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 años) fueron incluidos en el estudio, con la siguiente distribución: LNH folicular 67%, LNH del manto 14%, LNH difuso de células B grandes 9,5% y LNH transformado 9,5%. Se trató a 12 pacientes con LNH refractario, 7 para consolidación de respuesta y 2 para acondicionamiento a trasplante. El 71% de los pacientes presentó efectos adversos, generalmente manejables y transitorios, siendo la trombocitopenia el más frecuente. A los 3-4 meses, se obtuvo una tasa de respuesta global del 76,2% (completa en 71,4% y parcial en 4,8%) y el 19% mostró progresión de su enfermedad. Con una mediana de seguimiento de 70 meses, la SG fue 96<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8 y la SLP de 54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11 meses.</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La RIT presentó una moderada correlación con las guías clínicas y probablemente esté infrautilizada. Los efectos adversos fueron frecuentes, leves y manejables. Los datos muestran una alta tasa de respuesta completa y una prolongación de la SG y la SLP.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Método" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martínez A, Martínez-Ramirez M, Martínez-Caballero D, Beneit P, Clavel J, Figueroa G, et al. Radioinmunoterapia en el linfoma no Hodgkin, posicionamiento, seguridad y eficacia de <span class="elsevierStyleSup">90</span>Y-ibritumomab. Experiencia y seguimiento a los 10 años. Rev Esp Med Nucl Imagen Mol. 2017;36:13–19.</p>" ] ] "multimedia" => array:10 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 958 "Ancho" => 1653 "Tamanyo" => 74953 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Number of lymph node chains affected and FLIPI index.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 604 "Ancho" => 1604 "Tamanyo" => 55163 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Adverse reactions.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 889 "Ancho" => 1646 "Tamanyo" => 55561 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Time to recovery and need for blood transfusion.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1097 "Ancho" => 1340 "Tamanyo" => 40904 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Duration of response in months. CR: complete response; OR: overall response.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1562 "Ancho" => 2674 "Tamanyo" => 134776 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Kaplan–Meier survival curves. OS: median overall survival in months; PFS: median progression-free survival in months.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age, years (mean</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">±</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sex</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 women (52%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Type of NHL, n (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Follicular lymphoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (67) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Transformed follicular lymphoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mantel cell lymphoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diffuse large B cell lymphoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Stages, <span class="elsevierStyleItalic">n (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (19) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (43) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (38) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Histological grade, n (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (33.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (43) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">B symptoms, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">FLIPI, n (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (27) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (19) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Lines of chemotherapy, n (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (14.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1301620.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Demographic characteristics of the patients studied.</p>" ] ] 6 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Thrombocytopenia \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Leucopenia \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Anemia \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 (90.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Grade 1, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Grade 2, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Grade 3, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Grade 4, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1301619.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Post-treatment hematotoxicity with Zevalin<span class="elsevierStyleSup">®</span>.</p>" ] ] 7 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Asthenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (38) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Upper respiratory cold \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nausea-vomiting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Oral ulcers \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cystitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Facial flushing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Myelodysplastic syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Second neoplasm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1301617.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">General adverse effects following Zevalin<span class="elsevierStyleSup">®</span>.</p>" ] ] 8 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of response \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Complete response \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (71.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Partial response \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (4.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stable disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (4.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Progression \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (19) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1301618.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Types of response at 3–4 months after treatment with Zevalin<span class="elsevierStyleSup">®</span>.</p>" ] ] 9 => array:8 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at5" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sex, n (male/female)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5/2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age, years (mean</span><span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Histological grade, n</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Stage, n</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">B symptoms, n</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">No. lymph node chains affected, median</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous lines of chemotherapy, mean</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Elevated LDH, n</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dose of</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">90</span></span><span class="elsevierStyleItalic">Y-ibritumomab in MBq, mean</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1028.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1301621.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Patients in disease remission.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0155" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Sociedad Española de Oncología Médica. Linfoma no Hodgkin. Available from: <a id="intr0010" class="elsevierStyleInterRef" href="http://www.seom.org/es">http://www.seom.org/es</a> [accessed November 2015]." ] ] ] 1 => array:3 [ "identificador" => "bib0160" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term results with radiotherapy for stage I–I follicular lymphomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.B. Wilder" 1 => "D. Jones" 2 => "S.L. Tucker" 3 => "L.M. Fuller" 4 => "C.S. Ha" 5 => "P. McLaughlin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Radiat Oncol Biol Phys" "fecha" => "2001" "volumen" => "51" "paginaInicial" => "1219" "paginaFinal" => "1227" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11728680" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0165" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.M. Ardeshna" 1 => "P. Smith" 2 => "A. Norton" 3 => "B.W. Hancock" 4 => "P.J. Hoskin" 5 => "K.A. MacLennan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2003" "volumen" => "362" "paginaInicial" => "516" "paginaFinal" => "522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12932382" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0170" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma German Low-Grade Lymphoma Study Group" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Hiddemann" 1 => "M. Kneba" 2 => "M. Dreyling" 3 => "N. Schmitz" 4 => "E. Lengfelder" 5 => "R. Schmits" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2005-01-0016" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2005" "volumen" => "106" "paginaInicial" => "3725" "paginaFinal" => "3732" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16123223" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0175" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recommendations for the use of yttrium-90 ibritumomab tiuxetan in malignant lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "O. Welgert" 1 => "T. Illidge" 2 => "W. Hiddemann" 3 => "M. Dreyling" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.22066" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2006" "volumen" => "107" "paginaInicial" => "686" "paginaFinal" => "695" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16826593" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0180" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictive value of Follicular Lymphoma International Prognostic Index (FLIPI) in patients with follicular lymphoma at first progression" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Montoto" 1 => "A. Lopez-Guillermo" 2 => "A. Ferrer" 3 => "G. Perea" 4 => "A. Ferrer" 5 => "M. Camós" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/annonc/mdh406" "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2004" "volumen" => "15" "paginaInicial" => "1484" "paginaFinal" => "1489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15367408" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0185" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Follicular lymphoma international prognostic index" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Solal-Celigny" 1 => "P. Roy" 2 => "P. Colombat" 3 => "J. White" 4 => "J.O. Armitage" 5 => "R. Arranz-Saez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2003-12-4434" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2004" "volumen" => "104" "paginaInicial" => "1258" "paginaFinal" => "1265" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15126323" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0190" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radioinmunoterapia en los linfomas no Hodgkin: desarrollo histórico y estado actual" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Emmanouilides" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl" "fecha" => "2006" "volumen" => "25" "paginaInicial" => "42" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16540013" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0195" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update on the rational use of Y-ibritumomab tiuxetan in the treatment of follicular lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Lehnert" 1 => "H. Ludwig" 2 => "N. Zojer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Onco Targets Ther" "fecha" => "2009" "volumen" => "2" "paginaInicial" => "199" "paginaFinal" => "208" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20616907" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0200" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radioimmunotherapy of B-cell non-Hodgkin's lymphoma: from clinical trials to clinical practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.E. Juweid" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nucl Med" "fecha" => "2002" "volumen" => "43" "paginaInicial" => "1507" "paginaFinal" => "1529" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12411555" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0205" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Non Hodgkin Lymphoma v4.2014. Clinical practice guideline. National Comprehensive Cancer Network (NCCN). Available from: <a id="intr0015" class="elsevierStyleInterRef" href="http://www.nccn.org/">http://www.nccn.org</a> [accessed 15.12.14]." ] ] ] 11 => array:3 [ "identificador" => "bib0210" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Newly diagnosed and relapsed follicular lymphoma: ESMO Clinical Practice. Guidelines for diagnosis, treatment and follow up" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Dreyling" 1 => "M. Ghielmini" 2 => "R. Marcus" 3 => "G. Salles" 4 => "U. Vitolo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/annonc/mdq321" "Revista" => array:7 [ "tituloSerie" => "Ann Oncol" "fecha" => "2011" "volumen" => "22" "numero" => "S-6" "paginaInicial" => "59" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20595451" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0215" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: <a class="elsevierStyleInterRef" id="intr0020" href="http://www.guiasalud.es/GPC/GPC_474_Linfoma_folicular.pdf">http://www.guiasalud.es/GPC/GPC_474_Linfoma_folicular.pdf</a> [accessed 10 Ene 2015]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guía de práctica clínica para el tratamiento de pacientes con linfoma folicular" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "GPC-LF" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2011" "editorial" => "Grupo GELTAMO y Sociedad Española de Hematología y Hemoterapia" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0220" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: <a class="elsevierStyleInterRef" id="intr0025" href="http://ctep.cancer.gov./forms/ctcae3.pdf">http://ctep.cancer.gov./forms/ctcae3.pdf</a> [accessed 15.02.13]" "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Common Terminology Criteria for Adverse Events (CTCAE v 4.0). National Cancer Institute, Cancer Therapy Evaluation Program" ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2010" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0225" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Phase III trial of consolidation therapy with yttrium-90-ibritumomab tiuxetan compared with no additional therapy after first remission in advanced follicular lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Morschhauser" 1 => "J. Radford" 2 => "A. van Hoof" 3 => "U. Vitolo" 4 => "P. Soubeyran" 5 => "H. Tilly" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2008.17.2015" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2008" "volumen" => "26" "paginaInicial" => "5156" "paginaFinal" => "5164" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18854568" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0230" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized controlled trial of yttrium-90-labeled ibritumomab tiuxetan radioimmunotherapy versus rituximab immunotherapy for patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin's lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.E. Witzig" 1 => "L.I. Gordon" 2 => "F. Cabanillas" 3 => "L.I. Gordon" 4 => "C. Emmanouilides" 5 => "R. Joyce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2002.11.076" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2002" "volumen" => "20" "paginaInicial" => "2453" "paginaFinal" => "2463" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12011122" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0235" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ibritumomab tiuxetan radioimmunotherapy for patients with relapsed or refractory non-Hodgkin lymphoma and mild thrombocytopenia: a phase II multicenter trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.A. Wiseman" 1 => "L.I. Gordon" 2 => "P.S. Multani" 3 => "T.E. Witzig" 4 => "S. Spies" 5 => "N.L. Bartlett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2002" "volumen" => "99" "paginaInicial" => "4336" "paginaFinal" => "4342" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12036859" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0240" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety of yttrium-90 ibritumomab tiuxetan radioimmunotherapy for relapsed low-grade, follicular or transformed non-Hodgkin's lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.E. Witzig" 1 => "C.A. White" 2 => "L.I. Gordon" 3 => "G.A. Wiseman" 4 => "C. Emmanoulides" 5 => "J.L. Murray" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2003" "volumen" => "21" "paginaInicial" => "263" "paginaFinal" => "270" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0245" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin's lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.E. Witzig" 1 => "I.W. Flinn" 2 => "L.I. Gordon" 3 => "C. Emmanouilides" 4 => "M.S. Czuczman" 5 => "M.N. Saleh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2002.11.017" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2002" "volumen" => "20" "paginaInicial" => "3262" "paginaFinal" => "3269" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12149300" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0250" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment-related myelodysplastic syndrome and acute myelogenous leukemia in patients treated with ibritumomab tiuxetan radioimmunotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.S. Czuczman" 1 => "C. Emmanouilides" 2 => "M. Darif" 3 => "T.E. Witzig" 4 => "G. LI." 5 => "S. Revell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2006.09.2882" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2007" "volumen" => "25" "paginaInicial" => "4285" "paginaFinal" => "4292" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17709799" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0255" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Second malignancy risks after non-Hodgkin's lymphoma and chronic lymphocytic leukemia: differences by lymphoma subtype" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.M. Morton" 1 => "R.E. Curtis" 2 => "M.S. Linet" 3 => "E.C. Bluhm" 4 => "M.A. Tucker" 5 => "N. Caporaso" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2010.29.1112" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2010" "volumen" => "28" "paginaInicial" => "4935" "paginaFinal" => "4944" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20940199" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0260" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bendamustine is effective therapy in patients with rituximab-refractory, indolent B-cell non-Hodgkin lymphoma: results from a multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.S. Kahl" 1 => "N.L. Bartlett" 2 => "J.P. Leonard" 3 => "L. Chen" 4 => "K. Ganjoo" 5 => "M.E. Williams" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.24714" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2010" "volumen" => "116" "paginaInicial" => "106" "paginaFinal" => "114" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19890959" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0265" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PI3K inhibition by idelalisib in patients with relapsed indolent lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.K. Gopal" 1 => "B.S. Kahl" 2 => "S. de Vos" 3 => "N.D. Wagner-Johnston" 4 => "S.J. Schuster" 5 => "W.J. Jurczak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1314583" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2014" "volumen" => "370" "paginaInicial" => "1008" "paginaFinal" => "1018" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24450858" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0270" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lenalidomide oral monotherapy produces durable responses in relapsed or refractory indolent non-Hodgkin's lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.E. Witzig" 1 => "P.H. Wiernik" 2 => "T. Moore" 3 => "C. Reeder" 4 => "C. Cole" 5 => "G. Justice" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2008.21.1169" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2009" "volumen" => "27" "paginaInicial" => "5404" "paginaFinal" => "5409" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19805688" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0275" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "90 yttrium ibritumomab tiuxetan as first line treatment for follicular lymphoma: 30 months of follow-up from an international multicenter phase II clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.W. Scholz" 1 => "A. Pinto" 2 => "W. Linkesch" 3 => "O. Lindén" 4 => "A. Viardot" 5 => "U. Keller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2011.41.1553" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2013" "volumen" => "31" "paginaInicial" => "308" "paginaFinal" => "313" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23233718" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0280" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term responses in patients with recurring or refractory B-cell non-Hodgkin lymphoma treated with yttrium 90 ibritumomab tiuxetan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.E. Witzig" 1 => "A. Molina" 2 => "L.I. Gordon" 3 => "C. Emmanouilides" 4 => "R.J. Schilder" 5 => "I.W. Flinn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.22617" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2007" "volumen" => "109" "paginaInicial" => "1804" "paginaFinal" => "1810" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17380530" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0285" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "90 yttrium-ibritumomab tiuxetan consolidation of first remission in advanced-stage follicular non-Hodgkin lymphoma. Updated results after a median follow-up of 7.3 years from the international, randomized, phase III first-line indolent trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Morschhauser" 1 => "J. Radford" 2 => "A. van Hoof" 3 => "B. Botto" 4 => "A.Z. Rohatiner" 5 => "G. Salles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2012.45.6400" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2013" "volumen" => "31" "paginaInicial" => "1977" "paginaFinal" => "1983" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23547079" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0290" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term efficacy of (90)Y ibritumomab tiuxetan therapy in follicular non-Hodgkin lymphoma and health-related quality of life" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.M. Andrade-Campos" 1 => "A.E. Montes-Limón" 2 => "G. Soro-Alcubierre" 3 => "J.M. Grasa" 4 => "L. Lopez-Gómez" 5 => "T. Baringo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00277-014-2145-6" "Revista" => array:6 [ "tituloSerie" => "Ann Hematol" "fecha" => "2014" "volumen" => "93" "paginaInicial" => "1985" "paginaFinal" => "1992" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24985089" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0295" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fractionated 90 Y-ibritumomab Tiuxetan radioimmunotherapy as an initial therapy of follicular lymphoma: an international phase II study in patients requiring treatment according to GELF/BNLI Criteria" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Illidge" 1 => "S. Mayes" 2 => "R. Pettengell" 3 => "A.T. Bates" 4 => "M. Bayne" 5 => "J.A. Radford" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2013.50.3110" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2014" "volumen" => "32" "paginaInicial" => "212" "paginaFinal" => "218" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24297953" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0300" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autologus stem cells transplantation after conditioning with yttrium-90 ibritumomab tiuxetan plus BEAM in refractory non-Hodgkin diffuse large B-cell lymphoma: Results of a prospective, multicenter, phase II clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Briones" 1 => "S. Novelli" 2 => "J.A. Garcia-Marco" 3 => "J.F. Tomas" 4 => "T. Bernal" 5 => "C. Grande" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3324/haematol.2013.093450" "Revista" => array:6 [ "tituloSerie" => "Haematologica" "fecha" => "2014" "volumen" => "99" "paginaInicial" => "505" "paginaFinal" => "510" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24162789" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003600000001/v1_201612291502/S2253808916300854/v1_201612291502/en/main.assets" "Apartado" => array:4 [ "identificador" => "7926" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003600000001/v1_201612291502/S2253808916300854/v1_201612291502/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808916300854?idApp=UINPBA00004N" ]
Journal Information
Share
Download PDF
More article options
Original Article
Radioimmunotherapy for non-Hodgkin's lymphoma: positioning, safety, and efficacy of 90Y-ibritumomab. 10 years of experience and follow-up
Radioinmunoterapia en el linfoma no Hodgkin: posicionamiento, seguridad y eficacia de 90Y-ibritumomab. Experiencia y seguimiento a los 10 años