Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.13/808592

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Title
Impact of pre-transplant rituximab on survival after autologous hematopoietic stem cell transplantation for diffuse large B cell lymphoma
Author/Creator
Fenske, Timothy S.;  Hari, Parameswaran N.;  Gale, Robert Peter;  Hale, Gregory A.;  Ilhan, Osman;  Khoury, H. Jean;  Lister, John;  Maharaj, Dipnarine;  Marks, David I.;  Munker, Reinhold;  Pecora, Andrew L.;  Rowlings, Philip A.;  Carreras, Jeanette;  Zhang, Mei-Jie;  Kamble, Rammurti T.;  Bolwell, Brian J.;  Cairo, Mitchell S.;  Champlin, Richard E.;  Chen, Yi-Bin;  Freytes, César O.
Institution
The University of Newcastle. Faculty of Health, School of Medicine and Public Health
Description
Incorporation of the anti-CD20 monoclonal antibody rituximab into front-line regimens to treat diffuse large B cell lymphoma (DLBCL) has resulted in improved survival. Despite this progress, however, many patients develop refractory or recurrent DLBCL and then undergo autologous hematopoietic stem cell transplantation (AuHCT). It is unclear to what extent pre-transplant exposure to rituximab affects outcomes after AuHCT Outcomes of 994 patients receiving AuHCT for DLBCL between 1996 and 2003 were analyzed according to whether rituximab was (n = 176; +R cohort) or was not (n = 818; -R cohort) administered with front-line or salvage therapy before AuHCT The +R cohort had superior progression-free survival (PFS; 50% vs 38%; P = .008) and overall survival (OS; 57% vs 45%; P = .006) at 3 years. Platelet and neutrophil engraftment were not affected by exposure to rituximab. Nonrelapse mortality (NRM) did not differ significantly between the 2 cohorts. In multivariate analysis, the +R cohort had improved PFS (relative risk of relapse/progression or death, 0.64; P <.001) and improved OS (relative risk of death, 0.74; P = .039). We conclude that pre-transplant rituximab is associated with a lower rate of progression and improved survival after AuHCT for DLBCL, with no evidence of impaired engraftment or increased NRM.
Relation
Biology of Blood and Marrow Transplantation Vol. 15, Issue 11, p. 1455-1464
Publisher Link
http://dx.doi.org/10.1016/j.bbmt.2009.07.017
Date
2009
Publisher
Elsevier
Keyword(s)
autologous hematopoietic stem cell transplantation;  lymphoma;  rituximab
Resource Type
journal article
Identifier
http://hdl.handle.net/1959.13/808592
Identifier
ISSN:1083-8791
Reviewed
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Subject
"Biology of Blood and Marrow Transplantation"
 
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