Maintenance rituximab or observation after frontline treatment with bendamustine-rituximab for follicular lymphoma

Brian T. Hill, Loretta Nastoupil, Allison M. Winter, Melody R. Becnel, James R Cerhan, Thomas Matthew Habermann, Brian K. Link, Matthew J. Maurer, Bita Fakhri, Prathima Reddy, Stephen D. Smith, Dhruvika Mukhija, Deepa Jagadeesh, Amrita Desai, Juan Pablo Alderuccio, Izidore S. Lossos, Pooja Mehra, Craig A. Portell, Max L. Goldman, Oscar Calzada & 9 others Jonathon B. Cohen, Mohammad J. Hussain, Nilanjan Ghosh, Paolo Caimi, Timothy Tiutan, Peter Martin, Abhigna Kodali, Andrew M. Evens, Brad S. Kahl

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Bendamustine (B) with rituximab (R) is a standard frontline treatment for medically fit follicular lymphoma (FL) patients. The safety and efficacy of maintenance rituximab (MR) after BR induction has not been formally compared to observation for FL, resulting in disparate practice patterns. Prospective trials have shown benefit of MR after R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) or R-CVP (rituximab, cyclophosphamide, vincristine, prednisone), yet recent data from the GALLIUM study comparing outcomes of patients treated with chemotherapy with R or obinutuzumab (G) showed higher than anticipated fatal adverse events with BR/BG. In order to assess the efficacy and tolerability of MR after BR, we retrospectively collected data on 640 newly diagnosed patients treated with FL. We found that patients who achieved partial remission (PR) after ≥4 cycles of BR had improved duration of response (DOR) with MR vs. no maintenance, whereas those in complete remission did not. These findings were confirmed in a validation cohort. In the entire study population, the known fatal adverse event rate after BR was 2·5% and did not significantly differ in those receiving MR versus no maintenance. [Correction added on 14 January 2019, after online publication: The preceding sentence has been corrected in this current version.] Within the limitations inherent to retrospective analysis, these data suggest that FL patients with a PR to BR experience prolongation of remission with MR with an acceptable safety profile.

Original languageEnglish (US)
Pages (from-to)524-535
Number of pages12
JournalBritish Journal of Haematology
Volume184
Issue number4
DOIs
StatePublished - Feb 1 2019

Fingerprint

Follicular Lymphoma
Maintenance
Observation
Therapeutics
Vincristine
Prednisone
Cyclophosphamide
Safety
Bendamustine Hydrochloride
Rituximab
Doxorubicin
Publications
Outcome Assessment (Health Care)
Drug Therapy

Keywords

  • bendamustine
  • follicular lymphoma
  • maintenance
  • rituximab

ASJC Scopus subject areas

  • Hematology

Cite this

Maintenance rituximab or observation after frontline treatment with bendamustine-rituximab for follicular lymphoma. / Hill, Brian T.; Nastoupil, Loretta; Winter, Allison M.; Becnel, Melody R.; Cerhan, James R; Habermann, Thomas Matthew; Link, Brian K.; Maurer, Matthew J.; Fakhri, Bita; Reddy, Prathima; Smith, Stephen D.; Mukhija, Dhruvika; Jagadeesh, Deepa; Desai, Amrita; Alderuccio, Juan Pablo; Lossos, Izidore S.; Mehra, Pooja; Portell, Craig A.; Goldman, Max L.; Calzada, Oscar; Cohen, Jonathon B.; Hussain, Mohammad J.; Ghosh, Nilanjan; Caimi, Paolo; Tiutan, Timothy; Martin, Peter; Kodali, Abhigna; Evens, Andrew M.; Kahl, Brad S.

In: British Journal of Haematology, Vol. 184, No. 4, 01.02.2019, p. 524-535.

Research output: Contribution to journalArticle

Hill, BT, Nastoupil, L, Winter, AM, Becnel, MR, Cerhan, JR, Habermann, TM, Link, BK, Maurer, MJ, Fakhri, B, Reddy, P, Smith, SD, Mukhija, D, Jagadeesh, D, Desai, A, Alderuccio, JP, Lossos, IS, Mehra, P, Portell, CA, Goldman, ML, Calzada, O, Cohen, JB, Hussain, MJ, Ghosh, N, Caimi, P, Tiutan, T, Martin, P, Kodali, A, Evens, AM & Kahl, BS 2019, 'Maintenance rituximab or observation after frontline treatment with bendamustine-rituximab for follicular lymphoma', British Journal of Haematology, vol. 184, no. 4, pp. 524-535. https://doi.org/10.1111/bjh.15720
Hill, Brian T. ; Nastoupil, Loretta ; Winter, Allison M. ; Becnel, Melody R. ; Cerhan, James R ; Habermann, Thomas Matthew ; Link, Brian K. ; Maurer, Matthew J. ; Fakhri, Bita ; Reddy, Prathima ; Smith, Stephen D. ; Mukhija, Dhruvika ; Jagadeesh, Deepa ; Desai, Amrita ; Alderuccio, Juan Pablo ; Lossos, Izidore S. ; Mehra, Pooja ; Portell, Craig A. ; Goldman, Max L. ; Calzada, Oscar ; Cohen, Jonathon B. ; Hussain, Mohammad J. ; Ghosh, Nilanjan ; Caimi, Paolo ; Tiutan, Timothy ; Martin, Peter ; Kodali, Abhigna ; Evens, Andrew M. ; Kahl, Brad S. / Maintenance rituximab or observation after frontline treatment with bendamustine-rituximab for follicular lymphoma. In: British Journal of Haematology. 2019 ; Vol. 184, No. 4. pp. 524-535.
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AU - Cerhan, James R

AU - Habermann, Thomas Matthew

AU - Link, Brian K.

AU - Maurer, Matthew J.

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AU - Goldman, Max L.

AU - Calzada, Oscar

AU - Cohen, Jonathon B.

AU - Hussain, Mohammad J.

AU - Ghosh, Nilanjan

AU - Caimi, Paolo

AU - Tiutan, Timothy

AU - Martin, Peter

AU - Kodali, Abhigna

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