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The role of rituximab maintenance in elderly patients with mantle cell lymphoma in first remission – single centre experience


Authors: S. Vokurka;  A. Jungová;  P. Jindra;  V. Vozobulová;  M. Schutzova;  M. Pachner;  D. Lysák;  L. Mohammadová;  K. Steinerová;  M. Hrabětová
Authors‘ workplace: Hematologicko-onkologické oddělení, Fakultní nemocnice Plzeň
Published in: Transfuze Hematol. dnes,21, 2015, No. 4, p. 206-213.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Introduction:
Mantle cell lymphoma (MCL) is a rare and prognostically unfavourable malignancy. CD20 antigen expression on the surface of lymphoma cells enables the potential addition of anti-CD20 immunotherapy to therapeutic regimens in order to improve treatment outcome.

Methods:
Analysis and comparison of time to relapse/progression (PFS) and overall survivor (OS) in patients with newly diagnosed MCL who completed initial induction therapy, achieved at least partial remission and who were given or not additional maintenance therapy with the anti-CD20 antibody rituximab (R) 375 mg/m2 q 3 months for a maximum 2 years. Patient sample: 25 patients diagnosed from 2001–2010, median age 73 (44–82) years, males 17/25 (68%), disease status after 1st line treatment: complete remission 17/25 (68%), partial remission 8/25 (32%).

Results:
Median PFS and probability of 3-year PFS in the group without rituximab maintenance (n = 12) versus maintenance (n = 13) was: 16 months and 15% versus 59 months and 77% (p = 0.0007). Median OS and probability of 3-year OS in the group without rituximab maintenance vs. maintenance was: 25 months and 34% versus 65 months and 85% (p = 0.03). The significant difference in both PFS and OS between the two groups of patients was also observed when these parameters were calculated from the end of induction treatment.

Conclusions:
Progression free survival and overall survival were significantly prolonged in patients who were not fit for intensified treatment, responded to initial induction therapy and who received maintenance therapy with rituximab. Given the advanced age of these patients and this clear extension of PFS and OS using a well-tolerated maintenance treatment, these results could be considered to have major clinical importance.

Key words:
lymphoma, immunotherapy, maintenance treatment, rituximab


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Haematology Internal medicine Clinical oncology
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