Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma
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- 15 May 2004
- journal article
- clinical trial
- Published by American Society of Hematology
- Vol. 103 (10), 3684-3688
- https://doi.org/10.1182/blood-2003-11-3911
Abstract
Patients with relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) who achieve complete response (CR) before autologous stem cell transplantation (ASCT) generally have better outcomes than those who achieve only partial response (PR). We investigated whether adding rituximab to the ifosfamide-carboplatin-etoposide (ICE) chemotherapy regimen (RICE) could increase the CR rate of patients with DLBCL under consideration for ASCT. Thirty-six eligible patients were treated with RICE, and 34 received all 3 planned cycles. The CR rate was 53%, significantly better than the 27% CR rate (P = .01) achieved among 147 similar consecutive historical control patients with DLBCL treated with ICE; the PR rate was 25%. Febrile neutropenia was the most frequent grade 3 or 4 nonhematologic toxicity; it occurred in 7.5% of delivered cycles. No patient had RICE-related toxicity that precluded ASCT. The median number of CD34+ cells per kilogram mobilized was 6.3 × 106. Progression-free survival rates of patients who underwent transplantation after RICE were marginally better than those of 95 consecutive historical control patients who underwent transplantation after ICE (54% vs 43% at 2 years; P = .25). RICE appears to induce very high CR rates in patients with relapsed and refractory DLBCL; however, further studies are necessary to determine whether this treatment regimen will improve outcomes after ASCT.Keywords
This publication has 25 references indexed in Scilit:
- Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphomaBlood, 2003
- Rituximab-Mediated Sensitization of B-Non-Hodgkin's Lymphoma (NHL) to Cytotoxicity Induced by Paclitaxel, Gemcitabine, and VinorelbineCancer Biotherapy & Radiopharmaceuticals, 2002
- The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphomaBone Marrow Transplantation, 1999
- Chimeric Anti-CD20 (IDEC-C2B8) Monoclonal Antibody Sensitizes a B Cell Lymphoma Cell Line to Cell Killing by Cytotoxic DrugsCancer Biotherapy & Radiopharmaceuticals, 1997
- The Role of Intensive Therapy and Autologous Blood and Marrow Transplantation for Chemotherapy‐Sensitive Relapsed and Primary Refractory Non‐Hodgkin’s Lymphoma: Identification of Major Prognostic GroupsBritish Journal of Haematology, 1996
- Autologous Bone Marrow Transplantation as Compared with Salvage Chemotherapy in Relapses of Chemotherapy-Sensitive Non-Hodgkin's LymphomaNew England Journal of Medicine, 1995
- Comparison of a Standard Regimen (CHOP) with Three Intensive Chemotherapy Regimens for Advanced Non-Hodgkin's LymphomaNew England Journal of Medicine, 1993
- High-Dose Therapy and Autologous Bone Marrow Transplantation after Failure of Conventional Chemotherapy in Adults with Intermediate-Grade or High-Grade Non-Hodgkin's LymphomaNew England Journal of Medicine, 1987
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958