Chemotherapy with rituximab followed by high-dose therapy and autologous stem cell transplantation in patients with mantle cell lymphoma.
BACKGROUND
The authors evaluated the efficacy of chemotherapy combined with rituximab followed by high-dose therapy (HDT) plus autologous stem cell transplantation in patients with mantle cell lymphoma (MCL).


METHODS
This was a retrospective analysis of 34 patients who were treated in 2 departments of hematology, including 29 patients (85%) who received first-line treatment. Rituximab was administered as 4 injections just before harvest in 25 patients (73%) or simultaneously with chemotherapy in 9 patients (27%). HDT included total body irradiation in 26 patients (77%).


RESULTS
After induction therapy, all patients except one reached a response: There were 14 (41%) complete responses (CR) and 19 (56%) partial responses (PR). Stem cell harvest was successful in all patients but 2, with a median number of 5.9 CD34-positive cells per 10(6)/kg. Three months after transplantation, 24 patients (71%) were in CR, and 7 patients (21%) were in PR. At 3 years from the day of transplantation, the estimated overall survival was 87%. With a median follow-up at 2.6 years, the estimated median time to disease progression was 3.4 years. Rituximab treatment before harvest did not delay hematopoietic reconstitution: The median time it took patients to recover absolute neutrophil count to > 0.5 G/L was 10 days.


CONCLUSIONS
Chemotherapy combined with rituximab followed by HDT improved the overall survival and progression-free survival in patients MCL without adding toxicities.
Thieblemont
Catherine
C
Service d'Hématologie Clinique, Centre Hospitalier Lyon Sud, Pierre-Bénite, France. catherine.thieblemont@chu-lyon.fr
Antal
Daciana
D
Lacotte-Thierry
Laurence
L
Delwail
Vincent
V
Espinouse
Daniel
D
Michallet
Anne-Sophie
AS
Traulle
Catherine
C
Bouafia-Sauvy
Fadhela
F
Giraud
Christine
C
Salles
Gilles
G
Guilhot
François
F
Coiffier
Bertrand
B
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007262:Infusions, Intravenous; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D012074:Remission Induction; D012189:Retrospective Studies; D018570:Risk Assessment; D000069283:Rituximab; D012720:Severity of Illness Index; D033581:Stem Cell Transplantation / Q000379:methods*; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab