No Risk of Second Primary Malignancies in Patients With NHL Receiving Rituximab

Survivors of non-Hodgkin lymphoma exposed to rituximab do not have an increased risk for developing second primary malignancies.
Survivors of non-Hodgkin lymphoma exposed to rituximab do not have an increased risk for developing second primary malignancies.

At a median follow-up of 6 years, survivors of non-Hodgkin lymphoma (NHL) exposed to rituximab do not have an increased risk for developing second primary malignancies, according to a meta-analysis published online ahead of print in the journal Annals of Oncology.1

Because rituximab induces a transient B-cell depletion and a dose-dependent T-cell inactivation that could impair T-cell immunosurveillance, researchers theorize that treatment with rituximab may increase the risk for developing a secondary primary malignancy. Therefore, researchers sought to perform a systematic review to compare the risk of second primary malignancies among patients treated or not treated with rituximab.

For the study, researchers analyzed data from 9 trials that included a total of 4621 patients with newly or relapsed/progressive B-cell NHL that were randomly assigned to receive rituximab or no rituximab plus or minus other treatment.

Results showed that at a median follow-up of 73 months, there were 169 second primary malignancies observed in patients randomly assigned to rituximab compared with 165 in patients not randomly assigned to receive rituximab (OR, 0.88; 95% CI: 0.66-1.19). Researchers found no association between gender, histology, or use of rixumab in first line or in maintenance and second primary malignancy risk.

The study also demonstrated no association between cumulative exposure of rituximab given as maintenance and second primary malignancy risk.

“Our meta-analysis suggests no SPM predisposition among NHL survivors exposed to rituximab at a median follow-up of 6 years,” the authors conclude.

REFERENCE

1. Fleury I, Chevret S, Pfreundschuh M, et al. Rituximab and risk of second primary malignancies in patients with non-Hodgkin lymphoma: a systematic review and meta-analysis [published online ahead of print December 17, 2015]. Ann Oncol. doi:10.1093/annonc/mdv616.

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