Maintenance rituximab following induction chemoimmunotherapy may prolong progression-free survival in mantle cell lymphoma: a pilot study from the Wisconsin Oncology Network. Ann Oncol 2006 Sep;17(9):1418-23
Date
06/13/2006Pubmed ID
16766582DOI
10.1093/annonc/mdl127Scopus ID
2-s2.0-33748751004 (requires institutional sign-in at Scopus site) 97 CitationsAbstract
BACKGROUND: There is no standard first line treatment for mantle cell lymphoma.
PATIENTS AND METHODS: This was a multicenter phase II pilot study of rituximab and modified hyper-fractionated cyclophosphamide, vincristine doxorubicin, dexamethasone (modified R-hyperCVAD) administered every 28 days for four to six cycles followed by rituximab maintenance therapy consisting of four weekly doses every 6 months for 2 years. Unlike traditional hyperCVAD regimens, no methotrexate or cytarabine was administered.
RESULTS: Of 22 patients, the overall response rate was 77% and the complete response rate was 64%. With a median follow-up time of 37 months in surviving patients, the median PFS was 37 months and the median OS was not reached. The achievement of a molecular remission did not correlate with improved outcome. The major toxicity was expected myelosuppression. Two patients died during induction treatment. There were no major adverse effects during maintenance therapy.
CONCLUSION: In a multicenter trial, modified R-hyperCVAD was tolerable and effective induction therapy for untreated MCL. Maintenance rituximab appeared to prolong PFS without increasing toxicity.
Author List
Kahl BS, Longo WL, Eickhoff JC, Zehnder J, Jones C, Blank J, McFarland T, Bottner W, Rezazedeh H, Werndli J, Bailey HH, Wisconsin Oncology NetworkAuthor
Walter L. Longo MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Antibodies, Monoclonal
Antibodies, Monoclonal, Murine-Derived
Antineoplastic Combined Chemotherapy Protocols
Cyclophosphamide
Dexamethasone
Disease-Free Survival
Doxorubicin
Drug Administration Schedule
Female
Humans
Immunosuppressive Agents
Lymphoma, Mantle-Cell
Male
Middle Aged
Pilot Projects
Remission Induction
Rituximab
Survival Analysis
Treatment Outcome
Vincristine
