Rituximab Induces Effective Clearance of Minimal Residual Disease in Molecular Relapses of Mantle Cell Lymphoma

Marco Ladetto, Michele Magni, Gloria Pagliano, Federica De Marco, Daniela Drandi, Irene Ricca, Monica Astolfi, Paola Matteucci, Anna Guidetti, Barbara Mantoan, Chiara Lobetti Bodoni, Manuela Zanni, Mario Boccadoro, Alessandro M. Gianni, Corrado Tarella

Research output: Contribution to journalArticle

Abstract

Molecular remission (MR) is associated with improved outcome in mantle cell lymphoma (MCL). If MR is not achieved, patients are at high risk of relapse. We retrospectively describe the molecular and clinical follow-ups of 4 patients with molecular relapses (M-rels) who were treated with rituximab. The 4 patients received rituximab-supplemented, high-dose sequential chemotherapy and autologous stem cell transplantation as induction treatment and achieved clinical remission and MR. M-rel was defined as polymerase chain reaction (PCR) positivity in 2 consecutive samples in the absence of clinical relapse. M-rels occurred at 3, 6, 39, and 52 months and were always confirmed by direct sequencing of the clonal rearrangement. Minimal residual disease was monitored by qualitative and real-time quantitative PCR. All patients received 4 courses of rituximab, with 2 additional infusions if PCR positivity remained. After 4-6 courses of rituximab, all patients re-entered MR. No clinical relapses were recorded at 3, 6, 18, and 62 months from treatment, although 1 patient had a second M-rel that was sensitive to rituximab. Our results indicate that rituximab is active against residual MCL cells and suggest that molecularly tailored maintenance therapy needs to be investigated in clinical trials.

Original languageEnglish
Pages (from-to)1270-1276
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume12
Issue number12
DOIs
Publication statusPublished - Dec 2006

Keywords

  • Maintenance therapy
  • Mantle cell lymphoma
  • Minimal residual disease
  • Molecular remission
  • Monoclonal antibodies

ASJC Scopus subject areas

  • Transplantation

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    Ladetto, M., Magni, M., Pagliano, G., De Marco, F., Drandi, D., Ricca, I., Astolfi, M., Matteucci, P., Guidetti, A., Mantoan, B., Bodoni, C. L., Zanni, M., Boccadoro, M., Gianni, A. M., & Tarella, C. (2006). Rituximab Induces Effective Clearance of Minimal Residual Disease in Molecular Relapses of Mantle Cell Lymphoma. Biology of Blood and Marrow Transplantation, 12(12), 1270-1276. https://doi.org/10.1016/j.bbmt.2006.07.007