Efficiency of in vivo purging with rituximab prior to autologous peripheral blood progenitor cell transplantation in B-cell non-Hodgkin's lymphoma: a single institution study.
BACKGROUND
Rituximab induces clinical response in advanced B-cell lymphoma and is efficient in removing circulating B-cell from peripheral blood. We therefore postulated that rituximab might be a useful in vivo purging agent before high-dose therapy in this setting.


METHODS
Fourteen patients with relapsed follicular, marginal zone and mantle cell lymphomas (11, two and one cases, respectively) and a PCR-detectable molecular marker were treated first with rituximab, then a mobilization chemotherapeutic regimen, followed by high-dose therapy with peripheral blood stem cell transplantation. PCR analyses were performed in peripheral blood before rituximab and during follow-up, and in harvest.


RESULTS
Harvests were free of PCR-detectable molecular marker in nine of the 11 studied cases (82%). After high-dose therapy, clinical complete remission was obtained in 13 (93%) patients and molecular remission in 11 (79%). With a median follow-up of 3 years, the 14 transplanted patients were alive, 11 of them remaining in clinical complete remission and eight in molecular remission at last follow-up.


CONCLUSIONS
Rituximab treatment followed by high dose therapy appears to be effective in achieving complete clinical and molecular response. In vivo harvest purging is predictive of prolonged clinical and molecular remission.
CHU Henri Mondor, Service d'Hématologie Clinique, Creteil, France. karim.belhadj@hmn.ap-hop-paris.fr
K
K
Belhadj
M-H
MH
Delfau-Larue
T
T
Elgnaoui
F
F
Beaujean
J-L
JL
Beaumont
C
C
Pautas
I
I
Gaillard
Y
Y
Kirova
A
A
Allain
P
P
Gaulard
J-P
JP
Farcet
F
F
Reyes
C
C
Haioun
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34 / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016465:Bone Marrow Purging / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D016393:Lymphoma, B-Cell / Q000473:pathology / Q000628:therapy*; D008224:Lymphoma, Follicular / Q000473:pathology / Q000628:therapy*; D020522:Lymphoma, Mantle-Cell / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D000069283:Rituximab; D016879:Salvage Therapy; D013234:Stem Cells / Q000473:pathology; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34; D000970:Antineoplastic Agents; D000069283:Rituximab