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This combination regimen, evaluated by the Mayo Clinic in a Phase 1 trial (NCT00477815), is designed as a conditioning treatment for patients with previously treated multiple myeloma undergoing autologous stem cell transplantation (ASCT). The regimen integrates radioimmunotherapy with standard high-dose chemotherapy. It consists of 90Y-ibritumomab tiuxetan (Zevalin), a murine monoclonal antibody targeting CD20 conjugated to the beta-emitting radioisotope yttrium-90, and rituximab, a chimeric anti-CD20 antibody. These are followed by high-dose melphalan, a bifunctional alkylating agent that causes DNA cross-linking. The goal of adding 90Y-ibritumomab tiuxetan to the melphalan conditioning is to deliver targeted radiation to malignant cells, potentially improving the depth of response before the infusion of autologous peripheral blood stem cells to restore hematopoiesis.
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