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Rituximab as adjuvant to high-dose therapy and autologous hematopoietic cell transplantation for aggressive non-Hodgkin lymphoma
Open accessAbstract
Based on the favorable safety profile and the independent activity of rituximab in B-cell lymphoma, we evaluated its efficacy and toxicity after high-dose therapy (HDT) and autologous hematopoietic cell transplantation (HCT). Thirty-five patients with diffuse large cell (25 patients), mantle cell (3 patients), transformed (3 patients), or other (4 patients) subtypes of B-cell lymphoma received HDT followed by a purged autologous graft. The rituximab schedule was 4 weekly infusions (375 mg/m2) starting at day 42 after HCT and, for patients 5 to 35, a second 4-week course 6 months after HCT. All planned therapy was completed in 29 patients. With 30 months' median follow-up, the 2-year event-free survival (EFS) rate was 83% and the overall survival (OS) rate was 88%. For 21 patients with relapsed or refractory large cell lymphoma, the EFS rate was 81% and the OS rate was 85%. Grades 3 to 4 neutropenia occurred in 19 (54%) patients. A prospective study of immune reconstitution included measurements of lymphocyte subsets, immunoglobulins, and response to vaccination. Serious infections were not observed despite delayed B-cell recovery in all patients and suppressed immunoglobulin G (IgG) levels and low pneumococcus antibody titers in a subset. Rituximab after HDT and HCT is feasible, and these phase 2 data support the current US Intergroup phase 3 trial in recurrent/refractory diffuse large cell lymphoma.
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Cited by
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Tilly, H., Gomes da Silva, M., Vitolo, U., Jack, A., Meignan, M., Lopez-Guillermo, A., Walewski, J., André, M., Johnson, P. W., Pfreundschuh, M., et al. (2015) · Annals of Oncology · doi:10.1093/annonc/mdv304 · Cited by 930
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Metadata
- Authors
- Horwitz, S. M., Negrin, R. S., Blume, K. G., Breslin, S., Stuart, M. J., Stockerl-Goldstein, K. E., Johnston, L. J., Wong, R. M., Shizuru, J. A., & Horning, S. J.
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2004-02-01
- Volume
- 103
- Issue
- 3
- Pages
- 777-783
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W2043799126
- Cited by
- 200
- References
- 0
- FWCI
- 11.43
- Type
- journal article
- Language
- en
- Open access
- bronze
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- The paper
- Horwitz, S. M., Negrin, R. S., Blume, K. G., Breslin, S., Stuart, M. J., Stockerl-Goldstein, K. E., Johnston, L. J., Wong, R. M., Shizuru, J. A., & Horning, S. J. (2004). Rituximab as adjuvant to high-dose therapy and autologous hematopoietic cell transplantation for aggressive non-Hodgkin lymphoma. Blood. https://doi.org/10.1182/blood-2003-04-1257
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