Effect of addition of rituximab to salvage chemotherapy on outcome of patients with diffuse large B-cell lymphoma relapsing after an autologous stem-cell transplantation.
BACKGROUND
We have investigated if rituximab-based salvage regimens improve response rates and survival of patients with diffuse large B-cell lymphoma (DLBCL) relapsing after an autologous stem-cell transplantation (ASCT).


METHODS
We have retrospectively analyzed 82 patients with DLBCL who received salvage therapy for relapse or progression after ASCT. Patients were divided into two groups, according to whether rituximab-based salvage regimens were given (n = 42, 'R-' group) or not (n = 40, 'R+' group) after ASCT.


RESULTS
Patients in the R+ group had better complete remission (CR) (55% versus 21.4%, P = 0.006) and overall response (OR) (75% versus 40.4%, P = 0.001) rates, and better 3-year event-free survival (EFS) (37% versus 9%, P = 0.002) and overall survival (OS) (50% versus 20%, P = 0.005) than patients in the R- group. Patients retreated with rituximab had better CR (42.9% versus 21.4%, P = 0.032) and OR (66.7% versus 40.4%, P = 0.019) rates, and better OS (36.2% versus 20% at 3 years, P = 0.05) and EFS (36.2% versus 9% at 3 years, P = 0.05) than patients who received chemotherapy alone at relapse after ASCT.


CONCLUSIONS
The addition of rituximab to salvage chemotherapy improves response rates and EFS in patients with relapsed DLBCL after ASCT. These patients may benefit from rituximab retreatment, although larger prospective studies are needed to confirm these results.
Department of Hematology, Hospital Doctor José Molina Orosa, Arrecife de Lanzarote. Electronic address: jmcvillas@hotmail.com.
J M
JM
Calvo-Villas
Department of Hematology, Complejo Asistencial de Zamora, Zamora.
A
A
Martín
Department of Hematology, Hospital Marqués de Valdecilla, Santander.
E
E
Conde
Department of Hematology, Hospital Clinico Universitario San Carlos, Madrid.
A
A
Pascual
Department of Hematology, Hospital Morales Meseguer, Murcia.
I
I
Heras
Department of Hematology, Hospital Juan Canalejo, La Coruña.
R
R
Varela
Department of Hematology, Hospital La Fe, Valencia.
J
J
de la Rubia
Department of Hematology, Hospital General de Jerez, Jerez de la Frontera.
M J
MJ
Ramirez
Department of Hematology, Hospital Gregorio Marañón, Madrid.
J L
JL
Díez-Martín
Department of Hematology, Clínica Universitaria de Navarra, Pamplona.
C
C
Panizo
Department of Hematology, Hospital Universitario de Canarias, Tenerife.
M J
MJ
Rodríguez-Salazar
Department of Hematology, Hospital Carlos Haya, Malaga.
M J
MJ
Pascual
Department of Hematology, Hospital General de Castellón, Castellón.
E M
EM
Donato
Department of Hematology, Institut Catalá d'Oncología-Hospital Duran i Reynals, L'Hospitalet de Llobregat.
E
E
González-Barca
Department of Hematology, Hospital Clínico Universitario, Salamanca, Spain.
M D
MD
Caballero
D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy*; D009367:Neoplasm Staging; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D016879:Salvage Therapy; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab