{"entity":{"id":"paper-ptld-1-risk-stratified-sequential-treatment-trappe-jco-2017","kind":"paper","name":"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","aka":[],"tldr":"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.\n\n111 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.","asOf":"2026-09-22","links":[{"label":"J Clin Oncol 2017","url":"https://doi.org/10.1200/JCO.2016.69.3564"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/27992268/"}],"tags":[],"related":[],"cancers":["post-transplant-lymphoproliferative-disorder"],"sections":[],"technologies":[],"targets":[],"drugs":["rituximab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["ptld-1"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2017,"doi":"10.1200/JCO.2016.69.3564","pmid":"27992268","authors":"Trappe RU, Dierickx D, Zimmermann H, et al.","paperType":"observational","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."],"whatItMeans":"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."],"changedPractice":true,"participants":126},"route":"/key-papers/paper-ptld-1-risk-stratified-sequential-treatment-trappe-jco-2017/","neighbours":{"cancer":[{"id":"post-transplant-lymphoproliferative-disorder","kind":"cancer","name":"Post-transplant lymphoproliferative disorder (PTLD)","route":"/cancers/post-transplant-lymphoproliferative-disorder/"}],"drug":[{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"}],"trial":[{"id":"ptld-1","kind":"trial","name":"PTLD-1","route":"/trials/ptld-1/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}