# PTLD-1: response to rituximab induction as a predictive marker allowing stratification into rituximab or R-CHOP consolidation in B-cell post-transplant lymphoproliferative disorder

Source: https://onco.cc/key-papers/paper-ptld-1-risk-stratified-sequential-treatment-trappe-jco-2017/  
OnCo record `paper-ptld-1-risk-stratified-sequential-treatment-trappe-jco-2017` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In lymphoma arising after an organ transplant, starting with rituximab alone and then choosing between more rituximab and chemotherapy by response gave complete remission in seven of ten patients and a median survival of more than six years.

## Summary

International prospective phase 2 trial of risk-stratified sequential treatment in CD20-positive post-transplant lymphoproliferative disorder after solid organ transplantation: four weekly rituximab infusions, then four further rituximab doses for patients in complete remission or four cycles of R-CHOP for all others.

111 of 126 patients responded (88 percent), 88 with a complete response (70 percent); the three-year response duration estimate was 82 percent and median overall survival 6.6 years. Grade 3 or 4 infections occurred in 34 percent and treatment-related mortality was 8 percent. Response to rituximab induction remained prognostic for survival.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Journal: Journal of Clinical Oncology
- Year: 2017
- DOI: 10.1200/JCO.2016.69.3564
- Authors: Trappe RU, Dierickx D, Zimmermann H, et al.
- Findings: Overall response 88 percent (95% CI 81 to 93); complete response 70 percent (61 to 77).; Three-year response duration 82 percent; median overall survival 6.6 years (95% CI 5.5 to 7.6).; Grade 3 or 4 infections 34 percent; treatment-related mortality 8 percent.
- What it means: Risk-stratified sequential treatment is the standard first-line approach to post-transplant lymphoproliferative disorder, sparing complete responders to rituximab from chemotherapy.
- Caveats: Single-arm phase 2; Burkitt, T-cell and CNS disease were excluded.

## Sources

- J Clin Oncol 2017: https://doi.org/10.1200/JCO.2016.69.3564
- PubMed: https://pubmed.ncbi.nlm.nih.gov/27992268/

## Connected records

- cancers: [Post-transplant lymphoproliferative disorder (PTLD)](https://onco.cc/cancers/post-transplant-lymphoproliferative-disorder/)
- drugs: [Rituximab](https://onco.cc/drugs/rituximab/)
- trials: [PTLD-1](https://onco.cc/trials/ptld-1/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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