Rituximab Maintenance Therapy after Autologous Stem-Cell Transplantation Prolongs Progression- Free Survival in Patients with Mantle-Cell Lymphoma

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Use of rituximab maintenance therapy prolongs progression-free survival (PFS) and overall survival (OS) in patients with mantle-cell lymphoma (MCL) after conventional chemotherapy treatment.1 It is not clear, however, whether with rituximab maintenance therapy can further improve outcomes of patients with MCL after autologous stem-cell transplantation (ASCT).

In this study, Dietrich and colleagues analyzed data from all patients with MCL who underwent ASCT at the University Hospital of Heidelberg from the year 2000 and onwards. Patients with MCL who received rituximab maintenance therapy after undergoing ASCT were compared (with regard to PFS and OS) with patients who underwent ASCT during the same time period but did not receive rituximab maintenance therapy.2

A total of 72 patients with MCL met the study inclusion criteria. Of these patients, 22 had participated in a phase 2 trial in which they received rituximab maintenance therapy for 2 years after undergoing ASCT. The patient’s median age was 60 years. Prior to ASCT, all 72 patients received rituximab and 45 patients were treated with high-dose cytarabine therapy. ASCT was performed after the first-line treatment in 51 patients. Overall, 27 patients achieved complete response prior to ASCT.2

Patients with and without rituximab maintenance therapy did not significantly differ with regard to age, upfront ASCT, complete response rates, and high-dose cytarabine therapy prior to ASCT. However, there was a trend that patients who received rituximab maintenance therapy underwent ASCT more recently (P = 0.06).2

The median observation time after ASCT was 56 months. For patients who did not receive rituximab maintenance therapy after ASCT, the 2-year PFS and the 2-year OS were 65% and 80%, respectively. For patients who received rituximab maintenance therapy after ASCT, the 2-year PFS and the 2-year OS were 90% and 88%, respectively. Univariate analysis revealed that rituximab maintenance therapy was associated with significantly better PFS (P=.014) but not OS.2

Dietrich and colleagues concluded that rituximab may prolong PFS in patients with MCL who underwent ASCT. Prospective studies are needed to confirm this preliminary finding.2

References:

  1. Kenkre VP, Long WL, Eickhoff JC, et al. Maintenance rituximab following induction chemo-immunotherapy for mantle cell lymphoma: long-term follow-up of a pilot study from the Wisconsin Oncology Network. Leuk Lymphoma. 2011;52:1675-1680.
  2. Dietrich S, Weidle J, Meissner J, et al. Rituximab maintenance therapy after autologous stem cell transplantation prolongs progression free survival in patients with mantle cell lymphoma. Blood. 2013;122. Abstract 3050.
Last modified: April 4, 2014
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