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Three years of an antibody every two months after a stem cell transplant kept younger people with mantle cell lymphoma in remission longer and helped them live longer.
A phase 3 trial in 299 patients younger than 66 at diagnosis with mantle-cell lymphoma. After four courses of R-DHAP induction (rituximab, dexamethasone, high-dose cytarabine and a platinum derivative), the overall response rate was 89 per cent and the complete response rate 77 per cent. Transplantation was performed in 257 patients, and 240 were randomised 1 to 1 to rituximab 375 mg per square metre every two months for three years or to observation after transplantation; 59 patients did not undergo randomisation. The primary endpoint was event-free survival after transplantation among randomised patients, with an event defined as progression, relapse, death, allergy to rituximab or severe infection.
At a median follow-up of 50.2 months from randomisation (range 46.4 to 54.2), four-year event-free survival was 79 per cent (95 per cent confidence interval 70 to 86) with rituximab against 61 per cent (51 to 70) with observation (p = 0.001), and four-year progression-free survival 83 per cent (73 to 88) against 64 per cent (55 to 73). Overall survival was also prolonged.
One of the few maintenance strategies in lymphoma that improved overall survival rather than only progression-free survival, and the reason three years of rituximab became standard after autologous transplantation in mantle cell lymphoma.
Shares TRIANGLE: ibrutinib with immunochemotherapy with or without autologous transplant versus immunochemotherapy and transplant in untreated mantle cell lymphoma, CCND1, Maintenance therapy, CD20 and the tag lymphoma-evidence.
Shares Catherine Thieblemont, LYSA (The Lymphoma Study Association), Maintenance therapy, Rituximab and the tag lymphoma-evidence.
Shares CCND1, Maintenance therapy, CD20, Rituximab and the tag lymphoma-evidence.
Shares Catherine Thieblemont, LYSA (The Lymphoma Study Association), Maintenance therapy, Rituximab and the tag lymphoma-evidence.
Shares TRIANGLE, CCND1, Maintenance therapy, CD20 and the tag lymphoma-evidence.
Shares TRIANGLE, CCND1, Maintenance therapy, CD20 and the tag lymphoma-evidence.
Shares LYSA (The Lymphoma Study Association), Maintenance therapy, CD20, Rituximab and the tag lymphoma-evidence.
Shares Autologous stem cell transplant (ASCT), Stem cell transplant in lymphoma: what it is still for, Cytarabine, CD20 and the tag lymphoma-evidence.