Abstract

We retrospectively compared outcomes of patients with relapsed/refractory non-Hodgkin lymphoma (NHL) who underwent stem cell transplantation (SCT) with stable disease or better following a novel combination of lenalidomide and rituximab (LR) treatment and did not undergo SCT in a phase I/II clinical trial. We retrospectively compared outcomes of patients who underwent SCT with that of patients who had stable disease or better following LR treatment and did not undergo SCT. Twenty-two patients enrolled in LR clinical trial and undergone SCT were identified, 13 with mantle cell lymphoma (MCL) and nine with large B-cell lymphoma (LBCL). All patients who underwent SCT achieved complete response. In the MCL subset, there were no significant differences between SCT and non-SCT groups except that non-SCT patients were older and had a higher mantle-cell international prognostic index score. There was no difference between SCT-group and non-SCT-group in response duration (P=0.3), progression-free survival (PFS) (P=0.304) and overall survival (OS) (P=0.87). In LBCL subgroup, there were no significant differences between two groups except that non-SCT group had a higher international prognostic index score. Patients with LBCL who underwent SCT had significantly longer response duration (P=0.001), PFS (P=0.000), and OS (P=0.003) than the non-SCT group. The novel therapeutic combination offers a bridge to SCT in patients with relapsed/refractory aggressive B-cell NHL.

Highlights

  • 40% of patients with aggressive B-cell non-Hodgkin lymphoma (B-nonHodgkin lymphoma (NHL)) experience disease relapse following initial immune-chemotherapy in the last years [1,2,3,4,5]

  • We found that patients with large B-cell lymphoma (LBCL) who underwent stem cell transplantation (SCT) had significantly longer response duration, progression-free survival (PFS), and overall survival (OS) than patients who received lenalidomide and rituximab (LR) without SCT

  • The novel combination of LR provides a bridge to SCT in our heavily pretreated patient population

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Summary

Introduction

40% of patients with aggressive B-cell non-Hodgkin lymphoma (B-NHL) experience disease relapse following initial immune-chemotherapy in the last years [1,2,3,4,5]. Results of PARMA study made high-dose chemotherapy with autologous stem cell transplantation (auto-SCT) the frontline therapy for younger and fitter patients with relapsed/refractory NHL after CHOP-like therapy.[6] Given the high rate of relapse after chemotherapy and auto-SCT, and the potential benefit of a graft-versus-lymphoma effect after allogeneic SCT www.impactjournals.com/oncotarget Variable All (n=22) MCL (n=13) LBCL* (n=9). Years(range) 59.4 (46-71) 59 (46-71) 60 (49-69) Sex, male 18(82%)

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