title: Rituximab-based pre-emptive treatment of molecular relapse in follicular and mantle cell lymphoma.
abstract: Pre-emptive rituximab (pRTX) might represent an effective approach for patients with follicular (FL) and mantle cell lymphoma (MCL) experiencing molecular relapse (M-rel). However, available experience is still limited. We retrospectively collected FL and MCL cases that underwent pRTX with four weekly rituximab infusions (375 mg/m²) due to molecular persistence or M-rel. M-rel was assessed using nested polymerase chain reaction (PCR) and real-time quantitative PCR using the Bcl-1/IGH, Bcl-2/IGH or the immunoglobulin heavy chain rearrangement. Twenty-three occurrences of M-rel or persistence were treated in 18 patients (nine MCL and nine FL). The pRTX reinduced molecular remission (MR) in 17/23 cases (7/9 FL and 10/14 MCL). The median time to MR reinduction was 4.5 months (range 3-12), and the median duration of the first MR reinduction was 34 months (range 12-72). In five MCL cases, pRTX was used to treat subsequent M-rels, with success in four cases. No clinical relapses were seen within 2 years of successful reinduction of MR. Progression-free survival after pRTX was 64 % at a median follow-up of 6 years. pRTX was feasible and safe and effectively reinduced MR in FL and MCL patients (74 %). Prospective trials are needed to verify the clinical benefit of similar approaches.
authors.affiliation: Division of Hematology, AOU San Giovanni Battista, University of Torino, via Genova 3, 10126, Torino, Italy, simone.ferrero@unito.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
authors.forename: Luigia
authors.initials: L
authors.lastname: Monitillo
authors.forename: Barbara
authors.initials: B
authors.lastname: Mantoan
authors.forename: Daniela
authors.initials: D
authors.lastname: Barbero
authors.forename: Elisa
authors.initials: E
authors.lastname: Genuardi
authors.forename: Sara
authors.initials: S
authors.lastname: Barbiero
authors.forename: Elisa
authors.initials: E
authors.lastname: Bernocco
authors.forename: Daniele
authors.initials: D
authors.lastname: Caracciolo
authors.forename: Marco
authors.initials: M
authors.lastname: Ruella
authors.forename: Daniela
authors.initials: D
authors.lastname: Drandi
authors.forename: Manuela
authors.initials: M
authors.lastname: Zanni
authors.forename: Federica
authors.initials: F
authors.lastname: Renna
authors.forename: Chiara
authors.initials: C
authors.lastname: Lobetti Bodoni
authors.forename: Angela
authors.initials: A
authors.lastname: Gueli
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Corrado
authors.initials: C
authors.lastname: Tarella
authors.forename: Marco
authors.initials: M
authors.lastname: Ladetto
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000235:genetics / Q000401:mortality* / Q000628:therapy*; D020522:Lymphoma, Mantle-Cell / Q000235:genetics / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab