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Pre-transplant rituximab improves survival in DLBCL

Pre-transplant rituximab improves survival in DLBCL

ATLANTA—Use of rituximab (Rituxan) in the pre-transplant setting significantly boosts both progression-free and overall survival for patients with diffuse large B-cell lymphoma (DLBCL), without impacting engraftment or treatment-related mortality.

Timothy S. Fenske, MD, of the Division of Neoplastic Diseases and Related Disorders, Medical College of Wisconsin, Milwaukee, presented these findings at ASH 2007 (abstract 19) on behalf of the Center for International Blood and Marrow Transplant Research (CIBMTR).

Outcomes have substantially improved with the addition of rituximab to first-line chemotherapy regimens such as CHOP. Yet many patients are refractory to such therapy or develop recurrent disease and are candidates for autologous hematopoietic stem cell transplantation (AuHCT).

It is not known if administering rituxi-mab prior to transplant and/or during conditioning therapy affects survival and/or engraftment. If so, this might affect traditional methods of risk assessment and patient selection for AuHCT.

This trial evaluated outcomes for 1,006 patients who underwent peripheral blood AuHCT for DLBCL between 1996 and 2003. Of these patients, 188 received rituximab prior to AuHCT (+R) while 818 did not (–R).

The two groups did not differ significantly except that the +R group had more patients age 61 or older (40% vs 23%, P < .001) and that the majority of the +R group (96%) underwent transplant between 1999 and 2003, while the majority of the –R group (93%) underwent transplant in 1996-2001 (P < .001).

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