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- Title
Prolonged clinical remissions in patients with relapsed or refractory follicular lymphoma treated with autologous stem cell transplantation incorporating rituximab.
- Authors
Berinstein, N.; Bhella, S.; Pennell, N.; Cheung, M.; Imrie, K.; Spaner, D.; Milliken, V.; Zhang, L.; Hewitt, K.; Boudreau, A.; Reis, M.; Chesney, A.; Good, D.; Ghorab, Z.; Hicks, L.; Piliotis, E.; Buckstein, R.
- Abstract
Three sequential phase II trials were conducted with different immunotherapy approaches to enhance the outcome of autologous transplant (high-dose therapy and autologous stem cell transplantation (HDT/ASCT)) for recurrent follicular lymphoma. Seventy-three patients were enrolled from 1996 to 2009. Patients received HDT/ASCT combined with (1) interferon-α 3 MU/m subcutaneously (SC) three times per week (TIW) for 2 years post-ASCT, (2) rituximab (R) 375 mg/m for in vivo purging 3-5 days pre-stem cell collection and 2 × 4 weekly R at 2 and 6 months post-ASCT, respectively, or (3) three infusions of R pre-stem cell collection followed by 6× R weekly and interferon-α 3 MU/m SC TIW. Although not statistically significant, progression-free survival (PFS) for patients who received rituximab was 56.4 and 49.1 % at 5 and 10 years compared to 36 and 21 % in those who did not receive rituximab. Molecular relapse post-HDT/ASCT was the strongest predictor of PFS in a multivariate analysis. Molecular relapse was coincident with or preceded clinical relapses in 84 % of patients who relapsed-median of 12 months (range 0-129 months). Adverse events included secondary malignancy, transformation to diffuse large B cell lymphoma, prolonged mostly asymptomatic hypogammaglobulinemia, and pulmonary fibrosis. The long-term toxicity profile must be considered when selecting patients for this treatment.
- Subjects
LYMPHOMAS; RITUXIMAB; MONOCLONAL antibodies; RETICULOENDOTHELIAL granulomas; STEM cells
- Publication
Annals of Hematology, 2015, Vol 94, Issue 5, p813
- ISSN
0939-5555
- Publication type
Article
- DOI
10.1007/s00277-014-2288-5