Autologous transplant for relapsed follicular lymphoma: impact of pre-transplant rituximab sensitivity

作者：Phipps Colin^*; Gopal Ajay K; Storer Barry E; Cassaday Ryan D; Press Oliver W; Till Brian G; Pagel John M; Palanca Wessels Maria C; Philip Mary; Bensinger William I; Holmberg Leona A; Shustov Andrei R; Green Damian J; Chauncey Thomas; Maloney David G; Libby Edward N III

来源：Leukemia and Lymphoma, 2015, 56(1): 92-96.

DOI：10.3109/10428194.2014.911866

• Follicular lymphoma
• autologous transplant
• rituximab-refractory

Patients with rituximab-refractory follicular lymphoma (FL) have limited options. Before the rituximab era, autologous stem cell transplant (ASCT) was shown to improve outcomes in chemotherapy-sensitive, relapsed FL, but the impact of rituximab-sensitivity on these results is unknown. We analyzed 194 consecutive relapsed patients with FL who underwent ASCT at out center and categorized them as rituximab-sensitive (RS, n = 35), rituximab-refractory (RR, n = 65) or no rituximab (NoR, n = 94) if transplanted before rituximab was used. Progression-free survival at 3 years was 85% in RS and 35% in RR patients (p = 0.0004). Only rituximab-sensitivity was significant on multivariate analysis with improved overall survival (OS) (hazard ratio [HR] 0.24, p = 0.01) and progression-free survival (PFS) (HR 0.35, p = 0.006) in RS patients and increased relapse in RR patients (HR 2.11, p = 0.01). Pre-transplant rituximab-sensitivity is a strong independent predictor of post-transplant outcomes in relapsed FL, although one-third of RR patients achieved a PFS of over 3 years with ASCT.

• 出版日期2015-1