Rituximab combined with DexaBEAM followed by high dose therapy as salvage therapy in patients with relapsed or refractory B‐cell lymphoma: mature results of a phase II multicentre study

Media type: E-Article
Title: Rituximab combined with DexaBEAM followed by high dose therapy as salvage therapy in patients with relapsed or refractory B‐cell lymphoma: mature results of a phase II multicentre study
Contributor: Kirschey, Sebastian; Flohr, Thomas; Wolf, Hans H.; Frickhofen, Norbert; Gramatzki, Martin; Link, Hartmut; Basara, Nadezda; Peter, Norma; Meyer, Ralf G.; Schmitz, Norbert; Weidmann, Eckhart; Banat, Andre; Schulz, Andrea; Kolbe, Karin; Derigs, Guenter; Theobald, Matthias; Hess, Georg
imprint: Wiley, 2015
Published in: British Journal of Haematology
Language: English
DOI: 10.1111/bjh.13234
ISSN: 0007-1048; 1365-2141
Keywords: Hematology
Origination:
Footnote:
Description: <jats:title>Summary</jats:title><jats:p>Salvage therapy followed by high‐dose therapy (<jats:styled-content style="fixed-case">HDT</jats:styled-content>) remains a mainstay for patients with relapsed lymphoma, however no optimal regimen has been defined. Here we report on the results of R‐Dexa<jats:styled-content style="fixed-case">BEAM</jats:styled-content> (rituximab, dexamethasone, carmustine, etoposide, cytarabine, melphalan) followed by <jats:styled-content style="fixed-case">HDT</jats:styled-content>. Patients aged 18–65 years, Eastern Cooperative Oncology Group performance score 0–2, with relapsed/refractory B‐cell non‐Hodgkin lymphoma (<jats:styled-content style="fixed-case">NHL</jats:styled-content>) were eligible. R‐Dexa‐<jats:styled-content style="fixed-case">BEAM</jats:styled-content> was given for two cycles followed by stem cell mobilization and <jats:styled-content style="fixed-case">HDT</jats:styled-content>. Primary endpoint of the trial was progression‐free‐survival (<jats:styled-content style="fixed-case">PFS</jats:styled-content>). One hundred and three patients were included: aggressive <jats:styled-content style="fixed-case">NHL</jats:styled-content> (<jats:styled-content style="fixed-case">aNHL</jats:styled-content>): diffuse large B‐cell lymphoma 55, mantle cell lymphoma 7, follicular lymphoma <jats:styled-content style="fixed-case">(FL</jats:styled-content>) grade 3: 5, indolent Lymphoma (<jats:styled-content style="fixed-case">iNHL</jats:styled-content>): <jats:styled-content style="fixed-case">FL</jats:styled-content> grade 1–2: 29, marginal zone lymphoma 6, Immunocytoma 1. The overall response rate after salvage therapy was 62% for <jats:styled-content style="fixed-case">aNHL</jats:styled-content> and 78% for <jats:styled-content style="fixed-case">iNHL</jats:styled-content> patients. 66% of patients with <jats:styled-content style="fixed-case">aNHL</jats:styled-content> and 86% with <jats:styled-content style="fixed-case">iNHL</jats:styled-content> underwent <jats:styled-content style="fixed-case">HDT</jats:styled-content>. Treatment‐related mortality for <jats:styled-content style="fixed-case">HDT</jats:styled-content> was 1·3%. For <jats:styled-content style="fixed-case">aNHL</jats:styled-content> patients, the median <jats:styled-content style="fixed-case">PFS</jats:styled-content> was 0·83 years with 44% alive at the median follow‐up of 7·3 years. Corresponding figures for <jats:styled-content style="fixed-case">iNHL</jats:styled-content> were: median <jats:styled-content style="fixed-case">PFS</jats:styled-content> 3·7 years and 72% alive after 8 years. The combination of rituximab with Dexa<jats:styled-content style="fixed-case">BEAM</jats:styled-content> followed by <jats:styled-content style="fixed-case">HDT</jats:styled-content> resulted in high response rates and sustained remissions in responders. R‐Dexa<jats:styled-content style="fixed-case">BEAM</jats:styled-content> followed by <jats:styled-content style="fixed-case">HDT</jats:styled-content> can be considered a valid salvage option for <jats:styled-content style="fixed-case">NHL</jats:styled-content>.</jats:p>

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