The influence of maintenance therapy of rituximab on the survival of elderly patients with follicular lymphoma. A retrospective analysis from the database of the Czech Lymphoma Study Group

Belada, David; Procházka, Vít; Janíková, Andrea; Campr, Vit; Blahovcova, Petra; Pytlík, Robert; Šýkorová, Alice; Klener, Pavel; Benešová, Kateřina; Pirnos, Jan; Ďuraš, Juraj; Móciková, Heidi; Trněný, Marek

doi:10.1016/j.leukres.2018.08.019

Cited by 3 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the characteristics of the MR-eligible patients in our study were similar to those of patients described in the Nordic collaborative (NC) 49 and the Czech Lymphoma Study Group (CLSG) studies. 50 These studies reported an average patient age of 61 years (NLCS, NC) to 70 years (CLSG), 76-87% with stage III/IV disease, and 19%-24% with grade 3a disease (NC).…”

Section: Discussionmentioning

confidence: 99%

“…40,[44][45][46] In a systematic review and meta-analysis of RCTs, MR was associated with improved OS, primarily in the relapsed or refractory setting. 47 Several reports have recently described real-world 1L practices and outcomes in FL in relation to the use of MR. [48][49][50][51] For instance, a German study reported improvement in complete response rates with maintenance therapy, 48 whereas Nordic 49 and Czech 50,51 studies reported improvement in OS with MR. In contrast, the largest-and, to date, only-nationwide study of real-world FL practices and outcomes in the United States, the NLCS, 27 did not reveal an association between MR and OS.…”

Section: Discussionmentioning

confidence: 99%

“…Following the landmark threshold adjustment, approximately 44% of patients in our cohort received MR, comparable to the rate reported in NLCS (45%) and lower than those reported in NC (50%) and CLSG (68%), indicating a difference in how the evidence regarding MR has been translated to practice by patients and physicians in different countries. 27,49,50 While our study did not involve a qualitative component to examine attitudes behind this adoption pattern, we believe it likely reflects the controversy regarding the efficacy of MR. In fact, during our human chart review, we found documentation of discussions as to whether to pursue MR, with physicians often relaying to patients that while MR improves PFS, it does not improve OS.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, our study joins two other studies examining the use of MR in FL patients treated in real-world settings which demonstrate an association between MR and OS benefit. 49,50 It is therefore important for clinicians to inform patients that conflicting evidence exists about the benefits of MR in this setting, rather than simply reporting an absence of OS benefit. The absence of OS benefit in PRIMA may be due to enrollment of a younger and healthier group of FL patients than is typically encountered in real-world settings.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports have recently described real‐world 1L practices and outcomes in FL in relation to the use of MR 48‐51 . For instance, a German study reported improvement in complete response rates with maintenance therapy, 48 whereas Nordic 49 and Czech 50,51 studies reported improvement in OS with MR.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Maintenance rituximab in Veterans with follicular lymphoma

et al. 2020

View full text Add to dashboard Cite

Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma. 1 While most patients are diagnosed with advanced disease, a majority have an excellent prognosis with a disease trajectory that can span decades, despite the fact that treatment options often carry substantial morbidity and are ultimately not curative. 2-4 Many FL patients present with aggressive disease with short term responses, frequent relapses, and early mortality. 5,6 Given the heterogeneity in

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Maintenance rituximab in Veterans with follicular lymphoma

et al. 2020

View full text Add to dashboard Cite

show abstract

Rituximab maintenance significantly reduces early follicular lymphoma progressions in patients treated with frontline R‐CHOP

Procházka

Belada

Janíková

et al. 2020

eJHaem

Self Cite

View full text Add to dashboard Cite

Twenty percent of patients with high‐tumor‐burden (HTB) follicular lymphoma (FL) develop progression/relapse of disease (POD) within 24 months of frontline immunochemotherapy. Unfortunately, about 50% of these patients die within 5 years since POD event. Rituximab maintenance was proven to reduce relapse rate in responding FL, but its role on preventing POD was not defined. We analyzed 1360 HTB‐FL patients from the Czech Lymphoma Study Group registry treated with frontline rituximab‐containing regimen. Of those, 950 cases received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP) and achieved complete or partial remission: 712 patients received rituximab maintenance (MAINT) and 238 were a historical observational cohort (OBS). We have proposed a modified POD24 (mPOD24) endpoint for the chemosensitive patients calculated from the end‐of‐induction (EOI). Survival rates since EOI were as follows: 5‐year overall survival (OS) 86.2% versus 94.5% in the OBS and MAINT groups, respectively (P < .001) and 5‐year progression‐free survival 58.5% (OBS) and 75.4% (MAINT) (P < .001). The Cox proportional hazards model showed a decrease in mPOD24 incidence in the MAINT group with the overall hazard rate reduced by 56% (hazard ratio = 0.44; P < .001). The cumulative incidence of mPOD24 was reduced from 24.1% in OBS to 10.1% in MAINT (P < .001). Comparison of non‐mPOD24 cases showed OS similar to that in the general population. Rituximab maintenance given after R‐CHOP resulted in a 2.4‐fold reduction in mPOD24 incidence. Once the non‐POD24 status is achieved, FL does not shorten the patients’ life expectancy.

show abstract

Clinical Outcomes of Patients With B-Cell Non-Hodgkin Lymphoma in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study

Pavlovsky¹,

Cubero

Agreda-Vásquez

et al. 2022

JCO Global Oncology

View full text Add to dashboard Cite

PURPOSE Real-world evidence on non-Hodgkin lymphoma (NHL) management in Latin America is currently lacking. The objective of this study was to describe treatment characteristics and outcomes of NHL in Latin America. METHODS A total of 2,967 patients with NHL with aggressive and indolent subtypes, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mantle-cell lymphoma (MCL), and mucosa-associated lymphoid tissue (MALT) lymphoma, with incident or prevalent diagnosis between 2006 and 2015, were retrospectively identified using clinical charts registered in the Hemato-Oncology Latin America Observational Registry. Associations between treatment regimen and age at diagnosis with clinical outcomes within each subtype were estimated using Cox proportional hazard regression. RESULTS Most patients with NHL received 1L chemoimmunotherapy, most commonly cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with/without rituximab. Five-year survival rates were higher for MALT lymphoma (90.8%) and FL (87.6%) versus DLBCL (69.0%) and MCL (57.1%), with variations between countries. The median overall survival from first relapse for patients with DLBCL was 6.6 years, with lower risk of death for those diagnosed at age < 65 years (hazard ratio = 0.732; P = .0161). Patients achieved a longer median progression-free survival with 1L rituximab-CHOP (R-CHOP) versus CHOP or rituximab, cyclophosphamide, vincristine, and prednisone (RCVP) (7.7 v 3.0 or 1.8 years, respectively). Use of regimens other than R-CHOP was associated with a higher risk of death/progression for patients with DLBCL (rituximab, ifosfamide, carboplatin, and etoposide/ifosfamide, carboplatin, and etoposide) and FL (CHOP). There was no relationship between treatment prescribed and age at diagnosis with outcomes from first/second relapse in DLBCL and FL. CONCLUSION Differences in treatment outcomes between NHL subtypes were observed, reflecting variations in NHL management and barriers to treatment access in Latin America. These data provide necessary evidence to understand NHL management in this region and highlight the need to improve treatment outcomes for these patients.

show abstract

The influence of maintenance therapy of rituximab on the survival of elderly patients with follicular lymphoma. A retrospective analysis from the database of the Czech Lymphoma Study Group

Cited by 3 publications

References 26 publications

Maintenance rituximab in Veterans with follicular lymphoma

Maintenance rituximab in Veterans with follicular lymphoma

Rituximab maintenance significantly reduces early follicular lymphoma progressions in patients treated with frontline R‐CHOP

Clinical Outcomes of Patients With B-Cell Non-Hodgkin Lymphoma in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study

Contact Info

Product

Resources

About