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CHOP and DHAP plus rituximab followed by autologous stem cell transplantation in mantle cell lymphoma: a phase 2 study from the Groupe d'Etude des Lymphomes de l'Adulte

Blood, ISSN: 0006-4971, Vol: 121, Issue: 1, Page: 48-53
2013
  • 242
    Citations
  • 0
    Usage
  • 188
    Captures
  • 0
    Mentions
  • 0
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    242
    • Citation Indexes
      237
    • Clinical Citations
      4
      • PubMed Guidelines
        4
    • Policy Citations
      1
      • 1
  • Captures
    188

Article Description

Treatment of mantle cell lymphoma (MCL) in younger patients remains a challenge. We report results of a phase 2 trial using cytarabine and rituximab as induction regimen before autologous stem cell transplantation. Patients younger than 66 years with stage 3 or 4 MCL were included. Treatment consisted of 3 courses of CHOP 21 with rituximab at the third one and 3 of R-DHAP. Responding patients were eligible for autologous stem cell transplantation with TAM6 or BEAM. Sixty patients were included. Median age was 57 years. Characteristics of patients were: BM involvement 85%, leukemic disease 48%, gastrointestinal involvement 52%, Performance Status > 16%, lactate dehydrogenase > 1N 38%, Mantle Cell Lymphoma International Prognostic Index (low 55%, intermediate 38%, high 13%). The overall response rate was 93% after (R)-CHOP and 95% after R-DHAP. Although uncommon after (R)-CHOP (12%), 57% of patients were in complete response after R-DHAP. With median follow-up of 67 months, median event-free survival is 83 months, and median overall survival is not reached. Five-year overall survival is 75%. Comparison with a previous study without rituximab shows improvement of outcome (median event-free survival, 51 vs 83 months). No toxic death or unexpected toxicities were observed. This study confirms that induction with rituximab and cytarabine-based regimens is safe and effective in MCL patients. This regimen is currently compared with R-CHOP 21 induction in a multicentric European protocol.

Bibliographic Details

http://www.sciencedirect.com/science/article/pii/S0006497120473239; http://dx.doi.org/10.1182/blood-2011-09-370320; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84872054301&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/22718839; https://ashpublications.org/blood/article/121/1/48/31039/CHOP-and-DHAP-plus-rituximab-followed-by; https://dx.doi.org/10.1182/blood-2011-09-370320; http://europepmc.org/abstract/med/22718839; http://www.bloodjournal.org/content/121/1/48; http://www.bloodjournal.org/content/121/1/48.abstract; http://www.bloodjournal.org/content/121/1/48.full.pdf; https://f1000.com/prime/717948630#eval793455900; http://www.bloodjournal.org/cgi/doi/10.1182/blood-2011-09-370320; http://www.bloodjournal.org/content/121/1/48?sso-checked=true; http://f1000.com/717948630#eval793455900; https://ashpublications.org/blood/article-pdf/121/1/48/1363075/zh800113000048.pdf; https://signin.hematology.org/Login.aspx?vi=9&vt=9defa6a6088d2b174404aa4fe35b563f228006ecd6a40d609278f9161597931ded22a6a6c916ddd2e3692da9c32705919562d57d4a736a167148eef4da4a0ea5d9b45543dab2e725afa4641c9ef395939541b51b808b2f6acdac4e1202f1dde9253183fa3b3bd1e1b475737c47990b98&DPLF=Y; http://www.bloodjournal.org/lookup/doi/10.1182/blood-2011-09-370320?sso-checked=true; https://f1000.com/prime/717948630#eval793453739; http://www.bloodjournal.org/lookup/doi/10.1182/blood-2011-09-370320; http://f1000.com/717948630#eval793453739; http://www.bloodjournal.org/content/121/1/48.long?sso-checked=true

Delarue, Richard; for the Groupe d'Etude des Lymphomes de l'Adulte (GELA); Haioun, Corinne; Ribrag, Vincent; Brice, Pauline; Delmer, Alain; Tilly, Herve; Salles, Gilles; Van Hoof, Achiel; Casasnovas, Olivier; Brousse, Nicole; Lefrere, Francois; Hermine, Olivier

American Society of Hematology

Biochemistry, Genetics and Molecular Biology; Immunology and Microbiology; Medicine

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