Rituximab maintenance therapy is feasible and leads to good survival rates among elderly patients with follicular lymphoma (FL), according to a study published in Leukemia Research

Although FL is an incurable disease, patients achieve good rates of progression-free survival (PFS) and overall survival (OS) after standard-care rituximab-based chemotherapy (R-CHEMO), and particularly when maintained with rituximab maintenance (RM). The effect of RM particularly among the elderly — older than 65 years — however, has not been adequately investigated. 

For this study, researchers retrospectively analyzed the outcomes of 232 patients with newly diagnosed follicular lymphoma who received first-line R-CHEMO followed by RM or observation; the R-CHEMO regimens most commonly used were rituximab, cyclophosphamide, vincristine, plus prednisone (R-CHOP) or rituximab, vincristine, plus prednisone (R-CVP). Only patients who responded to initial R-CHEMO (complete [CR] or partial remission [PR]) continued onto RM. 

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Results show that patients who received RM had improved treatment results; the 5-year OS among patients who received RM was 83.7% compared with 64.3% among patients who underwent observation only (P=.0012). 

R-CHOP induction therapy was found to lead to better outcomes vs R-CVP; 5-year OS among patients treated with R-CHOP±RM compared with R-CVP±RM was 84.9% and 65.0%, respectively (P=.0008). The authors did note, however, that median age of the patients in the R-CVP arm was higher. 

Five-year OS of patients achieving CR/unconfirmed CR (uCR) after first-line R-CHEMO and RM was 90.6% vs 68.3% in patients who only achieved PR after the same treatment (P=.0019).

The authors concluded that the “study supports published data of the clinical benefits of RM therapy in newly diagnosed FL in elderly patients in a real world setting in terms of a better progression free survival and overall survival rate.”

Reference

Belada D, Prochazka V, Janikova A, et al. The influence of maintenance therapy of rituximab on the survival of elderly patients with follicular lymphoma. A retrospective analysis from the database of the Czech Lymphoma Study Group[published online August 31, 2018]. Leuk Res. doi: 10.1016/j.leukres.2018.08.019