A 4-weekly course of rituximab is safe and improves tumor control for patients with minimal residual disease persisting 3 months after autologous hematopoietic stem-cell transplantation: results of a prospective multicenter phase II study in patients with follicular lymphoma.

Franck Morschhauser 1, * Christian Recher 2 Noël Milpied 3 Remy Gressin 4 Gilles Salles 5 Pauline Brice 6 Norbert Vey 7 Corinne Haioun 8 Philippe Colombat 9 Jean-François Rossi 10 Eric Deconinck 11 F. Lazreg 12 Loïc Bergougnoux 12 Georges Delsol 2 Michel Attal 2, 13
* Auteur correspondant
1 Service d'hématologie
2 Service d'hématologie
3 Service d'hématologie
4 Service d'hématologie
5 Service d'hématologie/oncologie
6 Service d'hématologie-oncologie adultes
7 Service d'Hématologie
8 Service d'hématologie clinique
9 Service d'hématologie [Tours]
10 Service d'hématologie et oncologie médicale
11 Service d'hématologie
12 Service d'Hématologie
13 Laboratoire d'Hématologie [Purpan]
Abstract : BACKGROUND: This study explored the efficacy and safety of rituximab as treatment of clinical or molecular residual disease after autologous stem-cell transplantation (ASCT) in follicular lymphoma (FL). PATIENTS AND METHODS: Forty patients with CD20+ FL and clinically (group A, n = 14) or clono-specific PCR-detectable (group B, n = 25) residual disease persisting 3 months after ASCT received rituximab 375 mg/m² once weekly for 4 weeks. RESULTS: Response rate at day 50 was 36% [90% confidence interval (CI) 15-61] in group A (World Health Organization criteria) and 52% (90% CI 34-70) in group B (conversion PCR-undetectable status to undetectable status). The best response rate was 71% [nine complete responses (CRs) and one partial response] in group A and 76% in group B. At 36 months, all 10 responses persisted in group A, whereas 46% of patients in group B still had PCR-undetectable disease. Furthermore, 68% of patients in group B were still in clinical CR. Rituximab after ASCT was safe with few grade 3-4 toxic effects (15% patients), mainly acute reactions and infections. CONCLUSION: Rituximab induced a high rate of durable CRs in patients with clinically detectable disease, as well as durable eradication of PCR-detectable disease in patients with FL after ASCT. Continued molecular responses assessed with a highly sensitive and clono-specific PCR technique were correlated with an excellent disease control.
keyword : follicular lymphoma autologous stem cell transplantation minimal residual disease rituximab
Type de document :
Article dans une revue
Annals of Oncology, Oxford University Press (OUP), 2012, 23 (10), pp.2687-95. 〈10.1093/annonc/mds202〉
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http://www.hal.inserm.fr/inserm-00862711
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Soumis le : mardi 17 septembre 2013 - 13:06:40
Dernière modification le : mardi 11 septembre 2018 - 15:18:55

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Franck Morschhauser, Christian Recher, Noël Milpied, Remy Gressin, Gilles Salles, et al.. A 4-weekly course of rituximab is safe and improves tumor control for patients with minimal residual disease persisting 3 months after autologous hematopoietic stem-cell transplantation: results of a prospective multicenter phase II study in patients with follicular lymphoma.. Annals of Oncology, Oxford University Press (OUP), 2012, 23 (10), pp.2687-95. 〈10.1093/annonc/mds202〉. 〈inserm-00862711〉

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