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This refers to a sequential chemo-immunotherapy regimen evaluated in a Phase II clinical trial conducted by the University of Arizona Cancer Center for patients with relapsed stage II-IV follicular non-Hodgkin lymphoma. The protocol involves initial cytoreduction using two cycles of the ESHAP chemotherapy combination, which consists of etoposide, methylprednisolone, cytarabine, and cisplatin. Following chemotherapy, patients with less than 25% bone marrow involvement receive radioimmunotherapy consisting of rituximab followed by yttrium-90-ibritumomab tiuxetan (Zevalin). Zevalin is a radioimmunotherapy agent comprising a murine anti-CD20 monoclonal antibody (ibritumomab) conjugated to the radioisotope yttrium-90 via the chelator tiuxetan. The regimen aims to debulk the tumor with chemotherapy before delivering targeted radiation to residual CD20-positive B-cells, thereby maximizing the efficacy of the radioimmunotherapy component.
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