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Rituximab maintenance therapy after autologous stem cell transplantation prolongs progression-free survival in patients with mantle cell lymphoma

Leukemia volume 28, pages 708–709 (2014)Cite this article

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Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoma, which is characterized by early dissemination and an unfavorable clinical course.1, 2 A common treatment for elderly MCL patients consists of chemotherapy (for example, CHOP or Bendamustin) in combination with the anti-CD20 monoclonal antibody Rituximab.3, 4 Only few patients achieve complete remission after chemo-immunotherapy, and relapse or progression occurs early within 1–3 years.1, 5 A recent report by the European MCL-Network suggests that this poor prognosis could be significantly improved by the rituximab maintenance treatment.6 In contrast, the standard treatment in younger patients (⩽60 years) with MCL is high-dose therapy and autologous stem cell transplantation (autoSCT) after a rituximab and high-dose cytarabine (HD-ARA-C) induction regimen.4, 7, 8 However, it is not clear if rituximab maintenance treatment can further improve the prognosis in this patient population. To address this question, we compared patients with MCL who have received rituximab maintenance treatment after autoSCT with those who were followed after autoSCT without any further treatment until progression in a single-centre retrospective study.

Eligible for this analysis were all patients who underwent autoSCT for MCL at our institution between 2000 and 2012. Patients with MCL who received rituximab maintenance therapy after autoSCT within a prospective phase II trail on the value of rituximab maintenance in B-cell lymphoma (every 3 months for 2 years, NCT number 01933711) were compared with patients who were transplanted during the same time period within or outside the aforementioned trial, but did not receive rituximab maintenance therapy. End points were progression-free survival (PFS) and overall survival (OS), measured from the time of transplantation. The impact of maintenance therapy on these end points was analyzed by multivariate cox regression analysis correcting for known confounders. Rituximab maintenance was considered as a time-dependent event in order to avoid that early progression before start of rituximab maintenance therapy may compromise results. For illustration purposes Kaplan–Meier landmark plots are provided.

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Authors and Affiliations

  1. Department of Hematology, University Hospital of Heidelberg, Heidelberg, Germany

    S Dietrich, J Weidle, M Rieger, J Meissner, A Radujkovic, A D Ho, P Dreger & M Witzens-Harig

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  1. S Dietrich
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  2. J Weidle
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  3. M Rieger
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  4. J Meissner
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  8. M Witzens-Harig
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Correspondence to S Dietrich.

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Dietrich, S., Weidle, J., Rieger, M. et al. Rituximab maintenance therapy after autologous stem cell transplantation prolongs progression-free survival in patients with mantle cell lymphoma. Leukemia 28, 708–709 (2014). https://doi.org/10.1038/leu.2013.332

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