BACKGROUND: Predictive factors of rituximab efficacy and its effect on the immune system are still not defined. PATIENTS AND METHODS: Three hundred and six patients with follicular or mantle cell lymphoma received four weekly doses of rituximab (induction) and no further treatment (arm A) or four more doses at 2-month intervals (arm B). RESULTS: Response rate to induction was 44%. Independent predictive factors for response were disease bulk <5 cm, follicular histology, normal hemoglobin and low lymphocyte count. Factors associated with event-free survival (EFS) were having responded to induction, having received not more than one line of therapy, Ann Arbor stage I-III, high lymphocyte count, disease bulk <5 cm, Fc-gamma receptor genotype VV and receiving prolonged treatment. B cells were suppressed by treatment but recovered after a median of 12 months in arm A and 18 months in arm B. The median IgM level after 1 year was normal in arm A but was decreased to 73% of baseline in arm B. We observed 24 serious adverse events, equally distributed between arms. Ten patients receiving induction only and six patients receiving prolonged treatment developed a second tumor. CONCLUSIONS: We defined the characteristics predicting response and EFS to rituximab. Prolonged treatment results in longer EFS at the cost of a longer reduction in B cell and IgM levels, but without additional clinical toxicity.
BACKGROUND: Predictive factors of rituximab efficacy and its effect on the immune system are still not defined. PATIENTS AND METHODS: Three hundred and six patients with follicular or mantle cell lymphoma received four weekly doses of rituximab (induction) and no further treatment (arm A) or four more doses at 2-month intervals (arm B). RESULTS: Response rate to induction was 44%. Independent predictive factors for response were disease bulk <5 cm, follicular histology, normal hemoglobin and low lymphocyte count. Factors associated with event-free survival (EFS) were having responded to induction, having received not more than one line of therapy, Ann Arbor stage I-III, high lymphocyte count, disease bulk <5 cm, Fc-gamma receptor genotype VV and receiving prolonged treatment. B cells were suppressed by treatment but recovered after a median of 12 months in arm A and 18 months in arm B. The median IgM level after 1 year was normal in arm A but was decreased to 73% of baseline in arm B. We observed 24 serious adverse events, equally distributed between arms. Ten patients receiving induction only and six patients receiving prolonged treatment developed a second tumor. CONCLUSIONS: We defined the characteristics predicting response and EFS to rituximab. Prolonged treatment results in longer EFS at the cost of a longer reduction in B cell and IgM levels, but without additional clinical toxicity.
Authors: Daniel O Persky; David Dornan; Bryan H Goldman; Rita M Braziel; Richard I Fisher; Michael Leblanc; David G Maloney; Oliver W Press; Thomas P Miller; Lisa M Rimsza Journal: Haematologica Date: 2012-01-22 Impact factor: 9.941
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Authors: Vaishalee P Kenkre; Fangxin Hong; James R Cerhan; Marcia Lewis; Leslie Sullivan; Michael E Williams; Randy D Gascoyne; Sandra J Horning; Brad S Kahl Journal: Clin Cancer Res Date: 2015-10-28 Impact factor: 12.531
Authors: Jonathan W Friedberg; Jennifer L Kelly; Donna Neuberg; Derick R Peterson; Jeffery L Kutok; Rabih Salloum; Thomas Brenn; David C Fisher; Elizabeth Ronan; Virginia Dalton; Lynn Rich; Diana Marquis; Paul Sims; Paul G Rothberg; Jane Liesveld; Richard I Fisher; Robert Coffman; Tim Mosmann; Arnold S Freedman Journal: Br J Haematol Date: 2009-06-10 Impact factor: 6.998