ISSN:
1569-8041
Keywords:
anti-CD20
;
chimeric monoclonal antibody
;
mantle-cell lymphoma
;
R.E.A.L. Classification
;
Rituximab
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background:A retrospective analysis was performed to delineatethe factors associated with response, and to determine the duration ofresponse, in 87 patients with CD20–positive mantle-cell lymphoma (MCL) treatedwith Rituximab (chimeric monoclonal anti-CD20 antibody) in two prior studies. Patients and methods:Patients with newly-diagnosed MCL (MCL1,n = 37), and previously-treated MCL (MCL2, n = 50), receivedsingle-agent Rituximab, in the context of two multicentre clinical studiesusing different schedules and doses, conducted in 1996 and 1997. A follow-upanalysis was performed at the end of 1998, including all 81 patients whocompleted therapy. Statistical modeling of factors associated with responsewas performed using ordered logistic regression. The duration of complete (CR)and partial response (PR), and the time to disease progression (TTP), werealso derived. Results:The overall response rate (RR) was 34% (30 of 87)(81 evaluable patients, RR 37%; CR 14%), and was equivalent forMCL1 and MCL2. On univariate analysis, elevated LDH (P = 0.004);prior therapy with alkylating agents (P = 0.01) or fludarabinephosphate (P = 0.04); WHO performance status = 2 (P = 0.02);MCL2 refractory to last prior therapy (P = 0.04); and splenomegaly(P = 0.04), each at the time of treatment with Rituximab, weresignificantly associated with a lower RR. On multivariate analysis, only LDH(P = 0.007) and prior alkylating agents (P = 0.03) retainedstatistical significance. At a median follow-up of 1.4 years, the median TTP was 7 months. The medianduration of response was one year, and was significantly longer for patientsachieving CR vs. PR (P = 0.04). Conclusions:Rituximab is active in MCL, and can induce completeresponses in a minority of patients. Elevated LDH at the time of therapy, andprior therapy with alkylating agents, are associated with a significantlylower RR. The duration of response of one year is similar to that previouslyreported in follicular lymphoma.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008309405678
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