Rituximab-based pre-emptive treatment of molecular relapse in follicular and mantle cell lymphoma

Simone Ferrero, Luigia Monitillo, Barbara Mantoan, Daniela Barbero, Elisa Genuardi, Sara Barbiero, Elisa Bernocco, Daniele Caracciolo, Marco Ruella, Daniela Drandi, Manuela Zanni, Federica Renna, Chiara Lobetti Bodoni, Angela Gueli, Roberto Passera, Pellegrino Musto, Mario Boccadoro, Corrado Tarella, Marco Ladetto

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1503-1511
Number of pages9
JournalAnnals of Hematology
Volume92
Issue number11
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Lymphoma
  • Minimal residual disease
  • PCR
  • Pre-emptive rituximab
  • Tailored treatment

ASJC Scopus subject areas

  • Hematology

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