Maintenance rituximab after autologous stem cell transplantation in patients with mantle cell lymphoma
High-dose therapy and autologous stem cell transplantation (ASCT) improves outcomes for patients with mantle cell lymphoma (MCL), but relapse ultimately occurs in most patients. Recently presented interim results from a phase III prospective trial suggest maintenance rituximab (MR) after ASCT for MC...
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| Veröffentlicht in: | Annals of oncology 2015-11, Vol.26 (11), p.2323-2328 |
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| creator | Graf, S.A. Stevenson, P.A. Holmberg, L.A. Till, B.G. Press, O.W. Chauncey, T.R. Smith, S.D. Philip, M. Orozco, J.J. Shustov, A.R. Green, D.J. Libby, E.N. Bensinger, W.I. Pagel, J.M. Maloney, D.G. Zhou, Y. Cassaday, R.D. Gopal, A.K. |
| description | High-dose therapy and autologous stem cell transplantation (ASCT) improves outcomes for patients with mantle cell lymphoma (MCL), but relapse ultimately occurs in most patients. Recently presented interim results from a phase III prospective trial suggest maintenance rituximab (MR) after ASCT for MCL improves progression-free survival (PFS). The maturation of these data and any benefit of MR on overall survival (OS) remain to be defined.
In this retrospective study, we examined a cohort of consecutive patients with MCL that underwent ASCT for MCL at our center and evaluated their outcomes according to whether they received MR after ASCT (n = 50) or did not (n = 107). MR was treated as a time-dependent covariate to account for variation in timing of its initiation.
MR was associated with an improved PFS [hazard ratio (HR) 0.44; confidence interval (CI) (0.24–0.80), P = 0.007] and overall survival (OS; HR 0.46; CI 0.23–0.93, P = 0.03) following a multivariate adjustment for confounding factors with a median follow-up of ∼5 years. Grade 4 neutropenia was increased (34% versus 18%, P = 0.04) in the MR group, but no effect on the rate of mortality unrelated to relapse was observed.
These data support that MR after ASCT for MCL confers a benefit in PFS and additionally suggest it may improve OS. General application of this strategy will require confirmation of benefit in prospective randomized trials. |
| doi_str_mv | 10.1093/annonc/mdv364 |
| format | Article |
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In this retrospective study, we examined a cohort of consecutive patients with MCL that underwent ASCT for MCL at our center and evaluated their outcomes according to whether they received MR after ASCT (n = 50) or did not (n = 107). MR was treated as a time-dependent covariate to account for variation in timing of its initiation.
MR was associated with an improved PFS [hazard ratio (HR) 0.44; confidence interval (CI) (0.24–0.80), P = 0.007] and overall survival (OS; HR 0.46; CI 0.23–0.93, P = 0.03) following a multivariate adjustment for confounding factors with a median follow-up of ∼5 years. Grade 4 neutropenia was increased (34% versus 18%, P = 0.04) in the MR group, but no effect on the rate of mortality unrelated to relapse was observed.
These data support that MR after ASCT for MCL confers a benefit in PFS and additionally suggest it may improve OS. General application of this strategy will require confirmation of benefit in prospective randomized trials.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdv364</identifier><identifier>PMID: 26347113</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Antineoplastic Agents - administration & dosage ; autologous transplantation ; Cohort Studies ; Combined Modality Therapy - methods ; Combined Modality Therapy - trends ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation - methods ; Hematopoietic Stem Cell Transplantation - trends ; Humans ; Lymphoma, Mantle-Cell - diagnosis ; Lymphoma, Mantle-Cell - therapy ; maintenance ; Maintenance Chemotherapy - methods ; Maintenance Chemotherapy - trends ; Male ; mantle lymphoma ; Middle Aged ; Original ; Retrospective Studies ; rituximab ; Rituximab - administration & dosage ; Transplantation, Autologous - methods ; Transplantation, Autologous - trends</subject><ispartof>Annals of oncology, 2015-11, Vol.26 (11), p.2323-2328</ispartof><rights>2015 European Society for Medical Oncology</rights><rights>The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><rights>The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-71c121ee580684997a3eaef9e109daa580771db6dcd20e6eb7d20a2f7fb4809f3</citedby><cites>FETCH-LOGICAL-c435t-71c121ee580684997a3eaef9e109daa580771db6dcd20e6eb7d20a2f7fb4809f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26347113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Graf, S.A.</creatorcontrib><creatorcontrib>Stevenson, P.A.</creatorcontrib><creatorcontrib>Holmberg, L.A.</creatorcontrib><creatorcontrib>Till, B.G.</creatorcontrib><creatorcontrib>Press, O.W.</creatorcontrib><creatorcontrib>Chauncey, T.R.</creatorcontrib><creatorcontrib>Smith, S.D.</creatorcontrib><creatorcontrib>Philip, M.</creatorcontrib><creatorcontrib>Orozco, J.J.</creatorcontrib><creatorcontrib>Shustov, A.R.</creatorcontrib><creatorcontrib>Green, D.J.</creatorcontrib><creatorcontrib>Libby, E.N.</creatorcontrib><creatorcontrib>Bensinger, W.I.</creatorcontrib><creatorcontrib>Pagel, J.M.</creatorcontrib><creatorcontrib>Maloney, D.G.</creatorcontrib><creatorcontrib>Zhou, Y.</creatorcontrib><creatorcontrib>Cassaday, R.D.</creatorcontrib><creatorcontrib>Gopal, A.K.</creatorcontrib><title>Maintenance rituximab after autologous stem cell transplantation in patients with mantle cell lymphoma</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>High-dose therapy and autologous stem cell transplantation (ASCT) improves outcomes for patients with mantle cell lymphoma (MCL), but relapse ultimately occurs in most patients. Recently presented interim results from a phase III prospective trial suggest maintenance rituximab (MR) after ASCT for MCL improves progression-free survival (PFS). The maturation of these data and any benefit of MR on overall survival (OS) remain to be defined.
In this retrospective study, we examined a cohort of consecutive patients with MCL that underwent ASCT for MCL at our center and evaluated their outcomes according to whether they received MR after ASCT (n = 50) or did not (n = 107). MR was treated as a time-dependent covariate to account for variation in timing of its initiation.
MR was associated with an improved PFS [hazard ratio (HR) 0.44; confidence interval (CI) (0.24–0.80), P = 0.007] and overall survival (OS; HR 0.46; CI 0.23–0.93, P = 0.03) following a multivariate adjustment for confounding factors with a median follow-up of ∼5 years. Grade 4 neutropenia was increased (34% versus 18%, P = 0.04) in the MR group, but no effect on the rate of mortality unrelated to relapse was observed.
These data support that MR after ASCT for MCL confers a benefit in PFS and additionally suggest it may improve OS. General application of this strategy will require confirmation of benefit in prospective randomized trials.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>autologous transplantation</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy - methods</subject><subject>Combined Modality Therapy - trends</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hematopoietic Stem Cell Transplantation - methods</subject><subject>Hematopoietic Stem Cell Transplantation - trends</subject><subject>Humans</subject><subject>Lymphoma, Mantle-Cell - diagnosis</subject><subject>Lymphoma, Mantle-Cell - therapy</subject><subject>maintenance</subject><subject>Maintenance Chemotherapy - methods</subject><subject>Maintenance Chemotherapy - trends</subject><subject>Male</subject><subject>mantle lymphoma</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Retrospective Studies</subject><subject>rituximab</subject><subject>Rituximab - administration & dosage</subject><subject>Transplantation, Autologous - methods</subject><subject>Transplantation, Autologous - trends</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUFP3DAQha0KVBbosdfKRy4BO07i-FKpQhQqgbjA2Zo4E9ZVYqe2s7D_vkahqD30NCPPp-d58wj5zNk5Z0pcgHPemYup34mm-kA2vG5U0bKKH5ANU6UoZC2qI3Ic40_GWKNK9ZEclY2oJOdiQ4Y7sC6hA2eQBpuWFztBR2FIGCgsyY_-yS-RxoQTNTiONAVwcR7BJUjWO2odnXOHLkX6bNOWTnk04gqP-2ne-glOyeEAY8RPb_WEPH6_eri8KW7vr39cfrstTCXqVEhueMkR65Y1baWUBIGAg8JstQfIz1Lyvmt605cMG-xkrlAOcuiqlqlBnJCvq-68dBP2Jm8VYNRzyK7CXnuw-t-Js1v95He6akrOBM8CZ28Cwf9aMCY92fhqBRzmO2guS6naWjKW0WJFTfAxBhzev-FMv2aj12z0mk3mv_y92zv9J4wMyBXAfKGdxaCjyXc12NuAJune2_9I_wZ6JKSm</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Graf, S.A.</creator><creator>Stevenson, P.A.</creator><creator>Holmberg, L.A.</creator><creator>Till, B.G.</creator><creator>Press, O.W.</creator><creator>Chauncey, T.R.</creator><creator>Smith, S.D.</creator><creator>Philip, M.</creator><creator>Orozco, J.J.</creator><creator>Shustov, A.R.</creator><creator>Green, D.J.</creator><creator>Libby, E.N.</creator><creator>Bensinger, W.I.</creator><creator>Pagel, J.M.</creator><creator>Maloney, D.G.</creator><creator>Zhou, Y.</creator><creator>Cassaday, R.D.</creator><creator>Gopal, A.K.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20151101</creationdate><title>Maintenance rituximab after autologous stem cell transplantation in patients with mantle cell lymphoma</title><author>Graf, S.A. ; Stevenson, P.A. ; Holmberg, L.A. ; Till, B.G. ; Press, O.W. ; Chauncey, T.R. ; Smith, S.D. ; Philip, M. ; Orozco, J.J. ; Shustov, A.R. ; Green, D.J. ; Libby, E.N. ; Bensinger, W.I. ; Pagel, J.M. ; Maloney, D.G. ; Zhou, Y. ; Cassaday, R.D. ; Gopal, A.K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-71c121ee580684997a3eaef9e109daa580771db6dcd20e6eb7d20a2f7fb4809f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>autologous transplantation</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy - methods</topic><topic>Combined Modality Therapy - trends</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hematopoietic Stem Cell Transplantation - methods</topic><topic>Hematopoietic Stem Cell Transplantation - trends</topic><topic>Humans</topic><topic>Lymphoma, Mantle-Cell - diagnosis</topic><topic>Lymphoma, Mantle-Cell - therapy</topic><topic>maintenance</topic><topic>Maintenance Chemotherapy - methods</topic><topic>Maintenance Chemotherapy - trends</topic><topic>Male</topic><topic>mantle lymphoma</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Retrospective Studies</topic><topic>rituximab</topic><topic>Rituximab - administration & dosage</topic><topic>Transplantation, Autologous - methods</topic><topic>Transplantation, Autologous - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Graf, S.A.</creatorcontrib><creatorcontrib>Stevenson, P.A.</creatorcontrib><creatorcontrib>Holmberg, L.A.</creatorcontrib><creatorcontrib>Till, B.G.</creatorcontrib><creatorcontrib>Press, O.W.</creatorcontrib><creatorcontrib>Chauncey, T.R.</creatorcontrib><creatorcontrib>Smith, S.D.</creatorcontrib><creatorcontrib>Philip, M.</creatorcontrib><creatorcontrib>Orozco, J.J.</creatorcontrib><creatorcontrib>Shustov, A.R.</creatorcontrib><creatorcontrib>Green, D.J.</creatorcontrib><creatorcontrib>Libby, E.N.</creatorcontrib><creatorcontrib>Bensinger, W.I.</creatorcontrib><creatorcontrib>Pagel, J.M.</creatorcontrib><creatorcontrib>Maloney, D.G.</creatorcontrib><creatorcontrib>Zhou, Y.</creatorcontrib><creatorcontrib>Cassaday, R.D.</creatorcontrib><creatorcontrib>Gopal, A.K.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Graf, S.A.</au><au>Stevenson, P.A.</au><au>Holmberg, L.A.</au><au>Till, B.G.</au><au>Press, O.W.</au><au>Chauncey, T.R.</au><au>Smith, S.D.</au><au>Philip, M.</au><au>Orozco, J.J.</au><au>Shustov, A.R.</au><au>Green, D.J.</au><au>Libby, E.N.</au><au>Bensinger, W.I.</au><au>Pagel, J.M.</au><au>Maloney, D.G.</au><au>Zhou, Y.</au><au>Cassaday, R.D.</au><au>Gopal, A.K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maintenance rituximab after autologous stem cell transplantation in patients with mantle cell lymphoma</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>26</volume><issue>11</issue><spage>2323</spage><epage>2328</epage><pages>2323-2328</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>High-dose therapy and autologous stem cell transplantation (ASCT) improves outcomes for patients with mantle cell lymphoma (MCL), but relapse ultimately occurs in most patients. Recently presented interim results from a phase III prospective trial suggest maintenance rituximab (MR) after ASCT for MCL improves progression-free survival (PFS). The maturation of these data and any benefit of MR on overall survival (OS) remain to be defined.
In this retrospective study, we examined a cohort of consecutive patients with MCL that underwent ASCT for MCL at our center and evaluated their outcomes according to whether they received MR after ASCT (n = 50) or did not (n = 107). MR was treated as a time-dependent covariate to account for variation in timing of its initiation.
MR was associated with an improved PFS [hazard ratio (HR) 0.44; confidence interval (CI) (0.24–0.80), P = 0.007] and overall survival (OS; HR 0.46; CI 0.23–0.93, P = 0.03) following a multivariate adjustment for confounding factors with a median follow-up of ∼5 years. Grade 4 neutropenia was increased (34% versus 18%, P = 0.04) in the MR group, but no effect on the rate of mortality unrelated to relapse was observed.
These data support that MR after ASCT for MCL confers a benefit in PFS and additionally suggest it may improve OS. General application of this strategy will require confirmation of benefit in prospective randomized trials.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26347113</pmid><doi>10.1093/annonc/mdv364</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Antineoplastic Agents - administration & dosage autologous transplantation Cohort Studies Combined Modality Therapy - methods Combined Modality Therapy - trends Disease-Free Survival Female Follow-Up Studies Hematopoietic Stem Cell Transplantation - methods Hematopoietic Stem Cell Transplantation - trends Humans Lymphoma, Mantle-Cell - diagnosis Lymphoma, Mantle-Cell - therapy maintenance Maintenance Chemotherapy - methods Maintenance Chemotherapy - trends Male mantle lymphoma Middle Aged Original Retrospective Studies rituximab Rituximab - administration & dosage Transplantation, Autologous - methods Transplantation, Autologous - trends |
| title | Maintenance rituximab after autologous stem cell transplantation in patients with mantle cell lymphoma |
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