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The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis

Mantle cell lymphoma (MCL) is a distinct subtype of B-cell lymphoma and commonly used induction immunochemotherapies include the anti-CD20 antibody rituximab. However, efficacy data for rituximab regarding overall survival (OS) in first line MCL therapy remain conflicting. We report long-term outcom...

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Autores principales: Fischer, Luca, Jiang, Linmiao, Bittenbring, Joerg Thomas, Huebel, Kai, Schmidt, Christian, Duell, Johannes, Metzner, Bernd, Krauter, Juergen, Glass, Bertram, Huettmann, Andreas, Schaefer-Eckart, Kerstin, Silkenstedt, Elisabeth, Klapper, Wolfram, Hiddemann, Wolfgang, Unterhalt, Michael, Dreyling, Martin, Hoster, Eva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492741/
https://www.ncbi.nlm.nih.gov/pubmed/37552322
http://dx.doi.org/10.1007/s00277-023-05385-1
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author Fischer, Luca
Jiang, Linmiao
Bittenbring, Joerg Thomas
Huebel, Kai
Schmidt, Christian
Duell, Johannes
Metzner, Bernd
Krauter, Juergen
Glass, Bertram
Huettmann, Andreas
Schaefer-Eckart, Kerstin
Silkenstedt, Elisabeth
Klapper, Wolfram
Hiddemann, Wolfgang
Unterhalt, Michael
Dreyling, Martin
Hoster, Eva
author_facet Fischer, Luca
Jiang, Linmiao
Bittenbring, Joerg Thomas
Huebel, Kai
Schmidt, Christian
Duell, Johannes
Metzner, Bernd
Krauter, Juergen
Glass, Bertram
Huettmann, Andreas
Schaefer-Eckart, Kerstin
Silkenstedt, Elisabeth
Klapper, Wolfram
Hiddemann, Wolfgang
Unterhalt, Michael
Dreyling, Martin
Hoster, Eva
author_sort Fischer, Luca
collection PubMed
description Mantle cell lymphoma (MCL) is a distinct subtype of B-cell lymphoma and commonly used induction immunochemotherapies include the anti-CD20 antibody rituximab. However, efficacy data for rituximab regarding overall survival (OS) in first line MCL therapy remain conflicting. We report long-term outcomes of a pooled trials analysis comparing Cyclophosphamide, Doxorubicine, Vincristine, Prednisone (CHOP) to R-CHOP in MCL to confirm efficacy on failure free survival (FFS) and OS in relevant subgroups. Untreated, adult MCL patients of two prospective trials assigned to CHOP or R-CHOP were included. Primary endpoints were FFS and OS, secondary endpoints included duration of response (DOR), secondary malignancies and OS after relapse. Between 1996 and 2003, 385 MCL patients were assigned to CHOP (201) or R-CHOP (184). After a median follow-up of 13.4 years, the addition of Rituximab significantly improved FFS (1.36 vs. 2.07 years, HR 0.62 (0.50–0.77)), OS (4.84 vs. 5.81 years, HR 0.78 (0.61–0.99)) and DOR (1.48 vs. 2.08 years, HR 0.67 (0.53–0.86)). Furthermore, Rituximab improved survival across different MCL risk groups. In a post-hoc analysis of OS after relapse comparing patients receiving chemotherapy with / without rituximab, rituximab maintained efficacy with a median OS of 3.10 vs. 2.11 years (HR 0.70, 0.54–0.91). The rate of secondary malignancies was 0.5 and 3.9% for hematological and 7 and 8% for non-hematological malignancies for CHOP and R-CHOP patients, respectively. We present mature results of a pooled MCL cohort, demonstrating prolonged FFS, OS and DOR for the combined immuno-chemotherapy, confirming the standard of care in first line treatment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00277-023-05385-1.
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spelling pubmed-104927412023-09-11 The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis Fischer, Luca Jiang, Linmiao Bittenbring, Joerg Thomas Huebel, Kai Schmidt, Christian Duell, Johannes Metzner, Bernd Krauter, Juergen Glass, Bertram Huettmann, Andreas Schaefer-Eckart, Kerstin Silkenstedt, Elisabeth Klapper, Wolfram Hiddemann, Wolfgang Unterhalt, Michael Dreyling, Martin Hoster, Eva Ann Hematol Original Article Mantle cell lymphoma (MCL) is a distinct subtype of B-cell lymphoma and commonly used induction immunochemotherapies include the anti-CD20 antibody rituximab. However, efficacy data for rituximab regarding overall survival (OS) in first line MCL therapy remain conflicting. We report long-term outcomes of a pooled trials analysis comparing Cyclophosphamide, Doxorubicine, Vincristine, Prednisone (CHOP) to R-CHOP in MCL to confirm efficacy on failure free survival (FFS) and OS in relevant subgroups. Untreated, adult MCL patients of two prospective trials assigned to CHOP or R-CHOP were included. Primary endpoints were FFS and OS, secondary endpoints included duration of response (DOR), secondary malignancies and OS after relapse. Between 1996 and 2003, 385 MCL patients were assigned to CHOP (201) or R-CHOP (184). After a median follow-up of 13.4 years, the addition of Rituximab significantly improved FFS (1.36 vs. 2.07 years, HR 0.62 (0.50–0.77)), OS (4.84 vs. 5.81 years, HR 0.78 (0.61–0.99)) and DOR (1.48 vs. 2.08 years, HR 0.67 (0.53–0.86)). Furthermore, Rituximab improved survival across different MCL risk groups. In a post-hoc analysis of OS after relapse comparing patients receiving chemotherapy with / without rituximab, rituximab maintained efficacy with a median OS of 3.10 vs. 2.11 years (HR 0.70, 0.54–0.91). The rate of secondary malignancies was 0.5 and 3.9% for hematological and 7 and 8% for non-hematological malignancies for CHOP and R-CHOP patients, respectively. We present mature results of a pooled MCL cohort, demonstrating prolonged FFS, OS and DOR for the combined immuno-chemotherapy, confirming the standard of care in first line treatment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00277-023-05385-1. Springer Berlin Heidelberg 2023-08-08 2023 /pmc/articles/PMC10492741/ /pubmed/37552322 http://dx.doi.org/10.1007/s00277-023-05385-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Fischer, Luca
Jiang, Linmiao
Bittenbring, Joerg Thomas
Huebel, Kai
Schmidt, Christian
Duell, Johannes
Metzner, Bernd
Krauter, Juergen
Glass, Bertram
Huettmann, Andreas
Schaefer-Eckart, Kerstin
Silkenstedt, Elisabeth
Klapper, Wolfram
Hiddemann, Wolfgang
Unterhalt, Michael
Dreyling, Martin
Hoster, Eva
The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis
title The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis
title_full The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis
title_fullStr The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis
title_full_unstemmed The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis
title_short The addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis
title_sort addition of rituximab to chemotherapy improves overall survival in mantle cell lymphoma—a pooled trials analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492741/
https://www.ncbi.nlm.nih.gov/pubmed/37552322
http://dx.doi.org/10.1007/s00277-023-05385-1
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